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Use of conservative and surgical foot care in an inception cohort of patients with rheumatoid arthritis

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Backhouse, Michael, Keenan, Anne-Maree, Hensor, Elizabeth M. A., Young, Adam, James, David, Dixey, Josh, Williams, Peter, Prouse, Peter, Gough, Andrew, Helliwell, Philip S. and Redmond, Anthony C. (2011) Use of conservative and surgical foot care in an inception cohort of patients with rheumatoid arthritis. Rheumatology, 50 (9). pp. 1586-1595. doi:10.1093/rheumatology/ker130 ISSN 1462-0324.

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Official URL: http://dx.doi.org/10.1093/rheumatology/ker130

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Abstract

Objectives. To describe conservative and surgical foot care in patients with RA in England and explore factors that predict the type of foot care received.

Methods. Use of podiatry and type of foot surgery were outcomes recorded in an inception cohort involving nine rheumatology centres that recruited patients with RA between 1986 and 1998 across England. Associations between patient-specific factors and service use were identified using univariate logistic regression analyses. The independence of these associations was then verified through multiple binary logistic regression modelling.

Results. Data were collected on 1237 patients with RA [66.9% females, mean (S.D.) age at disease onset = 54.36 (14.18) years, median DAS = 4.09 (1st quartile = 3.04, 3rd quartile = 5.26), median HAQ = 1 (0.50, 1.63)]. Interventions involving the feet in the cohort were low with only 364 (30%) out of 1218 receiving podiatry and 47 (4%) out of 1237 patients having surgery. At baseline, female gender, increasing age at onset, being RF positive and higher DAS scores were each independently associated with increased odds of seeing a podiatrist. Gender, age of onset and baseline DAS were independently associated with the odds of having foot surgery.

Conclusions. Despite the known high prevalence of foot pathologies in RA, only one-third of this cohort accessed podiatry. While older females were more likely to access podiatry care and younger patients surgery, the majority of the RA population did not access any foot care.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Rheumatology
Publisher: Oxford University Press
ISSN: 1462-0324
Official Date: September 2011
Dates:
DateEvent
September 2011Published
18 April 2011Available
Volume: 50
Number: 9
Page Range: pp. 1586-1595
DOI: 10.1093/rheumatology/ker130
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)

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