P185 Patients' and clinicians' perspectives on the clinical utility of the Rheumatoid Arthritis Foot Disease Activity Index

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Abstract Background/Aims Although patient-reported outcome measures (PROMs) are recommended in clinical practice, their application in primary care is limited. The Rheumatoid Arthritis Foot Disease Activity Index (RADAI-F5) is a validated PROM for assessing foot disease activity in rheumatoid arthritis (RA). This qualitative study aims to understand the clinical utility of the RADAI-F5 as a management tool for foot disease in RA. Methods Adult RA patients and rheumatologists, physiotherapists and podiatrists routinely involved in treating RA patients were recruited through convenience sampling. Recruitment continued until data saturation had been achieved. A 60-minute, semi-structured, one-on-one Microsoft Teams interview with participants was conducted. Interviews involved open-ended questions to explore barriers and facilitators to the clinical application of the RADAI-F5. These interviews were audio-recorded and transcribed verbatim, with each participant verifying the transcript to establish rigour and credibility. The transcripts were coded using Nvivo12, and inductive thematic data analysis was conducted to identify emerging themes. Results Eight RA participants: 7 females; mean [standard deviation, SD] age 52.4 [9.5], mean [SD] disease duration 16.1 [16.4] and eight clinicians; mean [SD] age 46.75 [5.3], mean [SD] years of clinical experience of 19.5 [2.21] participated. The RADAI-F5 has four key themes that support its clinical utility. These were as follows: ‘need for the RADAI-F5' because patients felt that feet were ignored during routine consultations and clinicians felt the need for a foot PROM that is accurate, short and quick to complete in clinical practice; ‘promoting patient-clinician communication' because it can identify areas of concern that may be under-recognized by clinicians; ‘guiding management' as implementing the RADAI-F5 could assist in the screening, monitoring foot disease status, and guiding future interventions; and ‘patient involvement,' since the tool may trigger patients to be more involved in their foot health self-management. Three themes were identified as potential barriers to implementation; ‘practical difficulties, including lack of time during appointments; ‘lack of validity', as clinicians were hesitant to use the RADAI-F5 until its validity is established further with the use of ultrasound imaging and clinical examination; and, ‘lack of an electronic database', since there is currently no electronic system for reporting RADAI-F5 results. Conclusion The results of this study suggest that the RADAI-F5 has significant potential as a clinical tool to aid foot disease management in RA. However, some barriers to implementation may need to be overcome to enable widespread uptake in rheumatology clinics. Disclosure A. Hoque: None.