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Research project: OptiFoot: Optimisation of foot care for people living with arthritis.

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In the UK 20 million people are reported to have some form of arthritis. Whilst mobility is a recommended component of healthy living for arthritis it assumes that feet are free from pain. Foot and ankle problems account for 8% of consultations in primary care however an evidence gap exists for robust research evidence about foot care provision in the UK for patients with rheumatoid arthritis and patients with osteoarthritis. Evidence suggests that podiatric foot care provision does not meet current recommended standards for these patients. Additionally, some of these patients are reporting that they are forcing themselves to walk through their foot pain in the requirement to exercise to manage their hip or knee arthritis or other problems such as heart disease. Many of these issues have not been given specific consideration by commissioners and service providers. Funder: National Institute for Health Research, College of Podiatry UK

The research involves two phases with a mixed methods approach of explanatory sequential design. A series of investigations will be performed with quantitative data collected first, followed by qualitative explanations providing an understanding of how and in what context the quantitative results occur. The results from these two phases will be integrated to inform the development and testing of a best practice foot care package for patients with rheumatoid arthritis and patients with osteoarthritis. Phase one involves analysis of a large quantitative data set, the Clinical Practice Research Datalink (CPRD), to define the burden of UK foot problems for patients with rheumatoid arthritis and patients with osteoarthritis. Additionally, a systematic review of guidelines will be performed to determine current evidence based recommendations for the management of foot health for patients who have rheumatoid arthritis and patients who have osteoarthritis. This search will be targeted at two levels: UK clinical practice (to inform phase 2) and International (to inform phase 3).

Phase two involves qualitative work to follow up and explore findings from phase one. Views of patients, GPs, clinicians, podiatry managers and commissioners will be sought to gain feedback on experiences of barriers and facilitators in the NHS to referral, access, provision and treatment for foot problems for patients with rheumatoid arthritis and patients with osteoarthritis. Phase three will be a feasibility study (25 patients with rheumatoid arthritis; 25 patients with osteoarthritis) of the implementation of the best foot care package within NHS clinical practice. Quantitative and qualitative evaluation of the feasibility study will be performed to refine the foot care package and to inform a future clinical trial. The outcomes will assess the potential for a future clinical trial and application for HTA funding to evaluate the effectiveness and cost effectiveness of best foot care for patients who have rheumatoid arthritis and patients who have osteoarthritis.

Associated research themes

Osteoarthritis

Footcare

Cost effectiveness

Research groups: Active Living and Rehabilitation, Active Living Technologies Cluster

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