Abstract
BackgroundArthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated (early) inflammatory arthritis (IA). Usually made of nylon and elastane (i.e. Lycra®), these arthritis gloves apply pressure with the aims of relieving hand pain, stiffness and improving hand function. However, a systematic review identified little evidence supporting their use. We therefore designed a trial to compare the effectiveness of the commonest type of arthritis glove provided in the United Kingdom (Isotoner gloves) (intervention) with placebo (control) gloves (i.e. larger arthritis gloves providing similar warmth to the intervention gloves but minimal pressure only) in people with these conditions.MethodsParticipants aged 18 years and over with RA or IA and persistent hand pain will be recruited from National Health Service Trusts in the United Kingdom. Following consent, participants will complete a questionnaire booklet, then be randomly allocated to receive intervention or placebo arthritis gloves. Within three weeks, they will be fitted with the allocated gloves by clinical specialist rheumatology occupational therapists. Twelve weeks (i.e. the primary endpoint) after completing the baseline questionnaire, participants will complete a second questionnaire, including the same measures plus additional questions to explore adherence, benefits and problems with glove-wear. A sub-sample of participants from each group will be interviewed at the end of their participation to explore their views of the gloves received. The clinical effectiveness and cost-effectiveness of the intervention, compared to placebo gloves, will be evaluated over 12 weeks. The primary outcome measure is hand pain during activity. Qualitative interviews will be thematically analysed.DiscussionThis study will evaluate the commonest type of arthritis glove (Isotoner) provided in the NHS (i.e. the intervention) compared to a placebo glove. The results will help occupational therapists, occupational therapy services and people with arthritis make informed choices as to the value of arthritis gloves. If effective, arthritis gloves should become more widely available in the NHS to help people with RA and IA manage hand symptoms and improve performance of daily activities, work and leisure. If not, services can determine whether to cease supplying these to reduce service costs.Trial registrationISRCTN Registry: ISRCTN25892131 Registered 05/09/2016
Highlights
Arthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated inflammatory arthritis (IA)
The primary objective is to assess whether there is a clinically important difference in self-reported dominant hand pain during daytime activity between participants with RA or IA receiving intervention gloves (Isotoner gloves) in addition to usual care compared to participants receiving placebo gloves (Jobskin classic oedema gloves fitted at least one size too big to ensure similar warmth is provided but minimal pressure only is applied), plus usual care
Ii. evaluate the cost-effectiveness of arthritis gloves compared with placebo gloves, taking into account the cost of the gloves and other healthcare resources used by participants
Summary
Arthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated (early) inflammatory arthritis (IA). Rheumatoid arthritis (RA) is a chronic inflammatory condition causing joint pain, swelling (synovitis), stiffness and muscle loss around affected joints [1]. It affects 1% of the population, and twice as many women as men. People with persistent synovitis, where other pathologies are ruled out (i.e. undifferentiated inflammatory arthritis (IA), who do not yet meet the criteria for RA [4]), require specialist care and DMARDs, and are treated as if they have RA [1]. A third are work disabled within 5 years [1]
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