Abstract
Objectives
Rheumatoid arthritis (RA) has an affinity to smaller joints, thus its effect on the foot/ankle is widely known. Despite this, there is lack of adherence to foot management standards by podiatrists. This research aimed to audit the adherence of these standards and compare them to well-established management standard adherence in the diabetic foot.
Methods
In this clinical audit, data was obtained via six National Health Service (NHS) podiatry departments in North-East London on service provision, management, treatment and professional development on both RA and diabetic foot health via foot management clinical audit tools. Descriptive analyses were conducted analysed to identify patterns and trends, with set standard compliance conditions calculated on Net Promotor Score ® (NPS) metric to allow for multi-comparison.
Results
All areas of RA foot health management were found to have poor compliance when compared to diabetes foot health management. When using NPS, no trust audited meet the majority of foot health standards in RA; with only two having a positive score (meeting the minimum standards) compared to all trusts posting a positive NPS on diabetes foot health standards.
Conclusions
Our results indicate that poor compliance into RA foot health standards is prevalent across the audited region and may be resulting in worsening foot outcomes despite a paradigm shift in other areas of RA management. Enhanced training and knowledge is required for better adherence to the standards set out and improve a foot health management in RA.
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