Foot Health Education for People with Rheumatoid Arthritis: '…. A Game of Chance…' – A Survey of Patients' Experiences

Abstract

Foot pathology in people with RA has a bio-psychosocial impact on their lives. Foot health and related information appears to be considered rarely within the medical consultation. Access to foot health information and services is limited owing to a lack of patient and/or health professional awareness, with a detrimental impact on the prognosis of their foot health. The importance of foot health in people with RA should be reinforced for patients and health professionals alike. Opportunities to discuss foot health within the medical consultation should be provided regularly. Copyright © 2015 John Wiley & Sons, Ltd.

A survey of people with foot problems related to rheumatoid arthritis and their educational needs

“…Participants rated the importance of the content of FHE as high overall, which supports the value that people with RA place on managing their foot health [18, 19]. Items about the impact that RA and its related medications have on the feet, the role of podiatrist, and the interventions that are used in foot health management and self-management rated particularly highly, showing synergy with the findings of a survey of practitioners’ perceptions of FHE [18].…”

“…This may be because younger participants tended to have shorter disease duration (<5 years) and therefore their educational needs were possibly not as defined. Alternatively, younger participants may have fewer foot symptoms, and hence less physical awareness of the impact that RA can potentially have on their foot health [18]. Further to this, the number of participants in the <59 years age group who had not received FHE ( n  = 198) was greater than those in the >60 years age group ( n  = 161) which could also have reduced their awareness of RA foot-related problems.…”

“…Items about the impact that RA and its related medications have on the feet, the role of podiatrist, and the interventions that are used in foot health management and self-management rated particularly highly, showing synergy with the findings of a survey of practitioners’ perceptions of FHE [18]. Female participants rated certain items higher than males: the role of the podiatrist, information about RA medication and its effect on the feet, contact details and information about treatment options were more likely to be rated as very important by female participants.…”

“…Being invited to articulate their foot health needs during the consultation is very important for people with RA to allow them to open a dialogue about their feet. However, this opportunity appears to be limited by time, the needs and assessment practices of the consulting practitioner in fulfilling their own clinical ‘agenda’ and the practitioners’ awareness of foot health problems related to RA [18]. Many participants in this study reported that they were not asked about their foot health either during the consultation with their podiatrist ( n  = 113) or with another AHP ( n  = 337), so this opportunity was lost.…”

Experiences of mobility for people living with rheumatoid arthritis who are receiving biologic drug therapy: implications for podiatry services

“…Despite this, there appears to be a lack of access to podiatry services for PwRA and this has been consistently reported within the recent literature relative to the UK [34, 35] and other countries [13, 36]. Whilst new models of foot care for PwRA have been proposed [37, 38] further exploration of these is recommended for implementation of such strategies within routine practice.…”