Better foot health management needed for RA patients
medwireNews: The majority of patients with rheumatoid arthritis (RA) do not receive appropriate foot care, UK research suggests.
The study authors carried out a clinical audit of adherence to RA foot management standards at six podiatry departments in London and found that “service provision was poor in all trusts,” with just 43% meeting all appropriate standards. None of the centers had dedicated podiatrist involvement in the multidisciplinary rheumatology team, and only one permitted assessment of RA patients within 6 weeks of diagnosis.
The team then used Net Promotor Scores (NPS) to compare RA foot health management with “the well-established foot management standards in diabetes,” finding that the trusts were not meeting 95% of current RA foot standards, compared with 40% of diabetes foot standards. While all trusts had a positive NPS for diabetes foot health management – indicating that the minimum standards were met – only two trusts met this threshold for RA.
These findings indicate that “[d]espite research stating RA affinity to foot/ankle disease, there is a lack of appropriate management for these people,” say the study authors in Rheumatology Advances in Practice.
Christopher Joyce (Homerton University Hospital NHS Foundation Trust, London, UK) and Rizwan Rajak (Croydon Health Service NHS Trust, London) conclude that “[e]nhanced training and knowledge is required for better adherence to the standards set out and improve […] foot health management in RA.”
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