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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Psoriatic Arthritis | Research article

Health professional views on the assessment and management of foot problems in people with psoriatic arthritis in Australia and New Zealand: a qualitative investigation

Authors: Kate Carter, Steven Walmsley, Keith Rome, Deborah E. Turner

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

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Abstract

Background

Active foot disease persists in a high proportion of people with psoriatic arthritis despite the availability of pharmacological and non-pharmacological interventions to modify the course of the disease. Limited information exists on the provision of health care for foot disease in psoriatic arthritis. The objective of this study was to explore the views of health professionals on the assessment and management of people with psoriatic arthritis-related foot involvement.

Methods

Convenience sampling was used to recruit health professionals working in rheumatology outpatient clinics in Sydney, Australia and Auckland, New Zealand. Three focus groups were undertaken to explore the views and experiences of health professionals on the assessment and management of foot problems in people with psoriatic arthritis. All interviews were audio-recorded and transcribed verbatim. Qualitative data was analysed using a constant comparative analytic approach to identify themes.

Results

A total of seventeen health professionals participated including rheumatologists, podiatrists and a physiotherapist. Key themes derived from the focus groups suggest that health professionals perceived that people with psoriatic arthritis-related foot problems experience suboptimal management from symptom onset, to diagnosis and treatment. Frustration was expressed throughout discussions relating to lack of appropriate training and expertise required for the specialised management of foot problems typically encountered with psoriatic arthritis and poor access for patients to specialist podiatry services.

Conclusions

This study provides new insight into the perspectives of health professionals on the management of foot problems related to psoriatic arthritis. Deficiencies in the diagnosis, assessment and treatment of foot problems were revealed. To meet the foot health needs of people with psoriatic arthritis, reducing diagnostic delay, improving knowledge and awareness about the disease among people with psoriatic arthritis and health professionals, and increasing specialist podiatry service provision may be required.
Literature
1.
Coates LC, Helliwell PS. Psoriatic arthritis: state of the art review. Clin Med. 2017;17(1):65–70.CrossRef
2.
D’Angelo S, Palazzi C, Gilio M, Leccese P, Padula A, Olivieri I. Improvements in diagnostic tools for early detection of psoriatic arthritis. Expert Rev Clin Immunol. 2016;12(11):1209–15.CrossRefPubMed
3.
Raychaudhuri SP, Wilken R, Sukhov AC, Raychaudhuri SK, Maverakis E. Management of psoriatic arthritis: early diagnosis, monitoring of disease severity and cutting edge therapies. J Autoimmun. 2017;76:21–37.CrossRefPubMed
4.
Lebwohl MG, Kavanaugh A, Armstrong AW, Van Voorhees AS. US perspectives in the management of psoriasis and psoriatic arthritis: patient and physician results from the population-based multinational assessment of psoriasis and psoriatic arthritis (MAPP) survey. Am J Clin Dermatol. 2016;17(1):87–97.CrossRefPubMed
5.
Coates L, Savage L, Waxman R, Moverley A, Worthington S, Helliwell P. Comparison of screening questionnaires to identify psoriatic arthritis in a primary-care population: a cross-sectional study. Br J Dermatol. 2016;175(3):542–8.CrossRefPubMed
6.
Armstrong AW, Robertson AD, Wu J, Schupp C, Lebwohl MG. Undertreatment, treatment trends, and treatment dissatisfaction among patients with psoriasis and psoriatic arthritis in the United States: findings from the National Psoriasis Foundation surveys, 2003-2011. JAMA Dermatol. 2013;149(10):1180–5.CrossRefPubMed
7.
Garrido-Cumbrera M, Hillmann O, Mahapatra R, Trigos D, Zajc P, Weiss et al. Improving the management of psoriatic arthritis and axial spondyloarthritis: roundtable discussions with healthcare professionals and patients. Rheumatol Ther. 2017;4(2):219–31.CrossRefPubMedPubMedCentral
8.
Hyslop E, McInnes IB, Woodburn J, Turner DE. Foot problems in psoriatic arthritis: high burden and low care provision. Ann Rheum Dis. 2010;69(5):928.CrossRefPubMed
9.
Delle Sedie A, Riente L, Filippucci E, Scire CA, Iagnocco A, Meenagh G, et al. Ultrasound imaging for the rheumatologist. XXXII. Sonographic assessment of the foot in patients with psoriatic arthritis. Clin Exp Rheumatol. 2011;29(2):217–22.PubMed
10.
Galluzzo E, Lischi DM, Taglione E, Lombardini F, Pasero G, Perri G, et al. Sonographic analysis of the ankle in patients with psoriatic arthritis. Scand J Rheumatol. 2000;29(1):52–5.CrossRefPubMed
11.
Healy PJ, Groves C, Chandramohan M, Helliwell PS. MRI changes in psoriatic dactylitis—extent of pathology, relationship to tenderness and correlation with clinical indices. Rheumatology. 2008;47(1):92–5.CrossRefPubMed
12.
Woodburn J, Hennessy K, Steultjens MP, McInnes IB, Turner DE. Looking through the 'window of opportunity': is there a new paradigm of podiatry care on the horizon in early rheumatoid arthritis? J Foot Ankle Res. 2010;3(1):8.CrossRefPubMedPubMedCentral
13.
Hendry GJ, Gibson KA, Pile K, Taylor L, Du Toit V, Burns J, et al. “They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia. J Foot Ankle Res. 2013;6(1):34.CrossRefPubMedPubMedCentral
14.
Hendry GJ, Gibson KA, Pile K, Taylor L, Du Toit V, Burns J, et al. Provision of foot health services for people with rheumatoid arthritis in New South Wales: a web-based survey of local podiatrists. J Foot Ankle Res. 2013;6(1):35.CrossRefPubMedPubMedCentral
15.
Rome K, Gow PJ, Dalbeth N, Chapman JM. Clinical audit of foot problems in patients with rheumatoid arthritis treated at counties Manukau District health board, Auckland. New Zealand J Foot Ankle Res. 2009;2(1):16.CrossRefPubMed
16.
Patience A, Helliwell PS, Siddle HJ. Focussing on the foot in psoriatic arthritis: pathology and management options. Expert Rev Clin Immunol. 2018;14(1):21–8.CrossRefPubMed
17.
Liamputtong P, Ezzy D. Qualitative research methods. 2nd ed. Melbourne, Victoria: Oxford University Press; 2005.
18.
de Souza S, Williams R, Lempp H. Patient and clinician views on the quality of foot health care for rheumatoid arthritis outpatients: a mixed methods service evaluation. J Foot Ankle Res. 2016;9(1):1.CrossRefPubMedPubMedCentral
19.
McCulloch L, Borthwick A, Redmond A, Edwards K, Pinedo-Villanueva R, Prieto-Alhambra D, et al. UK podiatrists’ experiences of podiatry services for people living with arthritis: a qualitative investigation. J Foot Ankle Res. 2018;11(1):27.CrossRefPubMedPubMedCentral
20.
Carter K, Walmsley S, Chessman D, Rome K, Turner DE. Perspectives of patients and health professionals on the experience of living with psoriatic arthritis-related foot problems: a qualitative investigation. Clin Rheumatol. 2019;8:1–9.
21.
Morehouse RE, Maykut P. Beginning qualitative research. In: A philosophical and practical guide. 1st ed. London: Routledge; 1994.
22.
Williams A, Blake A, Cherry L, Alcacer-Pitarch B, Edwards C, Hopkinson N, et al. Patients’ experiences of lupus-related foot problems: a qualitative investigation. Lupus. 2017;0:1–8.
23.
Cresswell L, Chandran V, Farewell VT, Gladman DD. Inflammation in an individual joint predicts damage to that joint in psoriatic arthritis. Ann Rheum Dis. 2011;70(2):305–8.CrossRefPubMed
24.
Coates LC, FitzGerald O, Gladman DD, McHugh N, Mease P, Strand V, et al. Brief report: reduced joint counts misclassify patients with oligoarticular psoriatic arthritis and miss significant numbers of patients with active disease. Arthritis and Rheum. 2013;65(6):1504–9.CrossRef
25.
Hitchen E, Otter S. Foot assessment in rheumatology - not just for podiatrists [OP0225-HP]. Ann Rheum Dis. 2010;69(Suppl 3):726.
26.
Cauli A, Gladman DD, Mathieu A, Olivieri I, Porru G, Tak PP, et al. Patient global assessment in psoriatic arthritis: a multicenter GRAPPA and OMERACT study. J Rheumatol. 2011;38(5):898–903.CrossRefPubMed
27.
Garrow AP, Silman AJ, Macfarlane GJ. The Cheshire foot pain and disability survey: a population survey assessing prevalence and associations. Pain. 2004;110(1):378–84.CrossRefPubMed
28.
Otter SJ, Kumar S, Gow P, Dalbeth N, Corkill M, Rohan M, et al. Patterns of foot complaints in systemic lupus erythematosus: a cross sectional survey. J Foot Ankle Res. 2016;9(1):10.CrossRefPubMedPubMedCentral
29.
Roddy E, Myers H, Thomas MJ, Marshall M, D'Cruz D, Menz HB, et al. The clinical assessment study of the foot (CASF): study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population. J Foot Ankle Res. 2011;4(1):22.CrossRefPubMedPubMedCentral
Metadata
Title
Health professional views on the assessment and management of foot problems in people with psoriatic arthritis in Australia and New Zealand: a qualitative investigation
Authors
Kate Carter
Steven Walmsley
Keith Rome
Deborah E. Turner
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2572-6

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