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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.

The project, OptiFooT (Optimal FooT care) consisted of two phases that involved quantitative and qualitative exploration of referral and access to footcare services for people who have arthritis in the UK

In phase one using the UK NIHR CPRD (Clinical Practice Research Datalink) to report foot/ ankle pain encounters, the analyses indicated that foot/ankle pain is not insubstantial with 346067 patients over a 4-year period identified as reporting foot/ankle pain (1.8% of all GP encounters). The mean number of encounters for foot/ankle pain per person was 1.64 (SD: 1.3) i.e. on average, people who have foot/ankle pain are likely to see their GP more than once.  Despite this, the systematic review found that the literature on footcare and/or podiatry is concentrated around the assessment and prevention of foot and ankle problems related to the manifestations of diabetes.

The OptiFooT phase two research sought an explanation for this and analysed patient, clinician, GP and commissioner experiences of managing of foot problems across two regions of the UK (Yorkshire and Hampshire). An unmet foot-health need was consistently reported along with a perceived lack of appreciation of footcare and confusion over referral pathways to podiatry and foot-health services for people who have arthritis. A ‘barometer of foot-health needs’ accompanying an ‘advice pack for foot-health services’ was therefore created as an intervention to be delivered at 'first contact' in primary care to facilitate personalised choices of footcare and timelier referral to the most appropriately trained clinicians.

The OptiFooT programme has now progressed as a feasibility trial to evaluate the use of the ‘optimal foot-health information pack’ and the fidelity for a larger UK-wide trial. This OptiFooT work contributes an essential part of creating new and innovative ways for people who have arthritis to have control over their own foot health management.

Funder - National Institute for Health Research, College of Podiatry UK

Conferences and events

Invited to deliver Keynote Address for the College of Podiatry Conference. (Nov 2016).

Peer nominated to deliver the keynote address to the largest podiatry conference in Europe (1600+ delegates) on ‘raising the profile of podiatry through robust evidence’.

Associated research themes

Osteoarthritis

Footcare

Cost effectiveness

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

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