title: Use of conservative and surgical foot care in an inception cohort of patients with rheumatoid arthritis.
abstract: OBJECTIVE
  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.
authors.affiliation: Section of Musculoskeletal Disease, University of Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, UK. m.r.backhouse07@leeds.ac.uk
authors.forename: Michael R
authors.initials: MR
authors.lastname: Backhouse
authors.forename: Anne-Maree
authors.initials: AM
authors.lastname: Keenan
authors.forename: Elizabeth M A
authors.initials: EM
authors.lastname: Hensor
authors.forename: Adam
authors.initials: A
authors.lastname: Young
authors.forename: David
authors.initials: D
authors.lastname: James
authors.forename: Josh
authors.initials: J
authors.lastname: Dixey
authors.forename: Peter
authors.initials: P
authors.lastname: Williams
authors.forename: Peter
authors.initials: P
authors.lastname: Prouse
authors.forename: Andrew
authors.initials: A
authors.lastname: Gough
authors.forename: Philip S
authors.initials: PS
authors.lastname: Helliwell
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Redmond
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000601:surgery / Q000628:therapy*; D004739:England; D005260:Female; D005500:Follow-Up Studies; D005534:Foot Diseases / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011032:Podiatry / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult