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Journal of Foot and Ankle Research
Published in: Journal of Foot and Ankle Research 1/2017

Open Access 01-12-2017 | Research

Experiences of mobility for people living with rheumatoid arthritis who are receiving biologic drug therapy: implications for podiatry services

Authors: Lucy Sanders, Margaret Donovan-Hall, Alan Borthwick, Catherine J. Bowen

Published in: Journal of Foot and Ankle Research | Issue 1/2017

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Abstract

Background

Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease. In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility.

Methods

An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both ‘before’ and ‘after’ the instigation of biologic therapy. A purposive sampling strategy was adopted and in-depth semi structured interviews used to facilitate rich, detailed interview data exploring the lived experiences of individuals undertaking biological therapy and the changes to mobility experienced as a result. Thematic analysis was employed with an IPA framework to identify key meanings, and report patterns within the data.

Results

Five people with rheumatoid arthritis participated in the study. The mean disease duration was 20.2 years (range: 6 -32) and all were being treated with biologic therapies. Four key themes emerged from the data: 1) Life before biologic treatment, depicted in accounts as a negative experience characterised by painful and disabling symptoms and feelings of hopelessness. 2) Life with biologic treatment, often experienced as a life changing transition, restoring function and mobility and offering renewed hope. 3) Sense of self, in which the impact of rheumatoid disease and the subsequent changes arising from biologic therapy reveal a profound impact on feelings of personal identity both pre and post biologic therapy; an effect of footwear on self-image emerges as a dominant sub theme; 4) Unmet footcare needs were evident in the patient narrative, where the unrelenting if diminished impact of foot pain on mobility was viewed in the context of problematic access to foot health services.

Conclusion

Whilst the findings from this study mirror those within the existing literature, which report improvements in physical function related to biological therapy, foot problems clearly remained an unremitting feature of life for patients with rheumatoid disease, even when in receipt of biologics.
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Metadata
Title
Experiences of mobility for people living with rheumatoid arthritis who are receiving biologic drug therapy: implications for podiatry services
Authors
Lucy Sanders
Margaret Donovan-Hall
Alan Borthwick
Catherine J. Bowen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Foot and Ankle Research / Issue 1/2017
Electronic ISSN: 1757-1146
DOI
https://doi.org/10.1186/s13047-017-0195-4

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