title: Deficiencies in provision of integrated multidisciplinary podiatry care for patients with inflammatory arthritis: a UK district general hospital experience.
abstract: BACKGROUND
  Foot problems are highly prevalent in inflammatory arthritis (IA), especially rheumatoid arthritis (RA). Chronic inflammation can lead to permanent structural changes, deformity and disability. Early podiatry intervention in RA improves long term outcomes. National guidelines recommend that patients should be treated by a multidisciplinary team with dedicated podiatry services. In clinical practice funding constraints limit availability of these services.
  
  
  OBJECTIVE
  To assess prevalence of foot problems and quality and availability of foot care services at a UK district general hospital.
  
  
  METHODS
  1200 IA patients in Swindon (Wiltshire, UK) were invited to complete an anonymised questionnaire regarding access to foot care services and education/information on foot problems.
  
  
  RESULTS
  448 patients. Prevalence of foot problems: 68%. Only 31% of patients had access to appropriate foot specialist. 24% had received foot assessment within 3 months of diagnosis of IA and 17% yearly review thereafter.
  
  
  CONCLUSIONS
  Despite high prevalence of foot problems in our population we identified significant deficiencies in provision of integrated multidisciplinary podiatry care. The data we present could be used by others to support business cases to obtain funding to improve the links between rheumatology and podiatry services.
authors.affiliation: Rheumatology Department, The Great Western Hospitals NHS Foundation Trust, Swindon, United Kingdom. mariajuarezp@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Juarez
authors.forename: E
authors.initials: E
authors.lastname: Price
authors.forename: D
authors.initials: D
authors.lastname: Collins
authors.forename: L
authors.initials: L
authors.lastname: Williamson
mesh_terms: D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications; D001172:Arthritis, Rheumatoid / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D005534:Foot Diseases / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006767:Hospitals, District / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D011032:Podiatry; D015995:Prevalence; D012017:Referral and Consultation; D013167:Spondylitis, Ankylosing / Q000150:complications; D006113:United Kingdom / Q000453:epidemiology