Abstract
BackgroundIt is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists’ perceptions of the nature of podiatric foot care provision for people who have RA in NSW.MethodsAn anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices.Results86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self-referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents.ConclusionsThe results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms.
Highlights
It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations
Respondents podiatry practice characteristics Descriptive data regarding podiatry practice characteristics are presented in Figures 1, 2, 3 and 4. 86 podiatrists who practised in 8 regions of NSW participated in the survey, with 51 (69%) indicating they practised within Greater Sydney region boundaries (North Sydney, South East Sydney, Sydney South West, and Sydney West)
This study has provided a preliminary description of foot care provision for people who have RA in NSW, and has identified several potential shortfalls in foot care provision which should be explored through further research
Summary
It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. New South Wales (NSW) [3] It is unclear what specific foot care components are currently available to patients with RA who gain access to podiatry services. It is unclear whether podiatric foot care that is provided meets current evidence based recommendations [1,4,5,6,7,8] with regards to the assessment and management of disease-related foot problems in people with RA. The treat-to-target approach is where the goal of therapeutic intervention is to achieve an acceptable level of an outcome of importance (such as low levels of inflammatory disease activity) whereby further damage or deterioration will not occur [9]
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