title: Provision of foot health services for people with rheumatoid arthritis in New South Wales: a web-based survey of local podiatrists.
abstract: BACKGROUND
  It is unclear if podiatric foot care for people with rheumatoid arthritis (RA) in New South Wales (NSW) meets current clinical recommendations. The objective of this study was to survey podiatrists' perceptions of the nature of podiatric foot care provision for people who have RA in NSW.
  
  
  METHODS
  An anonymous, cross-sectional survey with a web-based questionnaire was conducted. The survey questionnaire was developed according to clinical experience and current foot care recommendations. State registered podiatrists practising in the state of NSW were invited to participate. The survey link was distributed initially via email to members of the Australian Podiatry Association (NSW), and distributed further through snowballing techniques using professional networks. Data was analysed to assess significant associations between adherence to clinical practice guidelines, and private/public podiatry practices.
  
  
  RESULTS
  86 podiatrists participated in the survey (78% from private practice, 22% from public practice). Respondents largely did not adhere to formal guidelines to manage their patients (88%). Only one respondent offered a dedicated service for patients with RA. Respondents indicated that the primary mode of accessing podiatry was by self-referral (68%). Significant variation was observed regarding access to disease and foot specific assessments and treatment strategies. Assessment methods such as administration of patient reported outcome measures, vascular and neurological assessments were not conducted by all respondents. Similarly, routine foot care strategies such as prescription of foot orthoses, foot health advice and footwear were not employed by all respondents.
  
  
  CONCLUSIONS
  The results identified issues in foot care provision which should be explored through further research. Foot care provision in NSW does not appear to meet the current recommended standards for the management of foot problems in people who have RA. Improvements to foot care could be undertaken in terms of providing better access to examination techniques and treatment strategies that are recommended by evidence based treatment paradigms.
authors: School of Science & Health, University of Western Sydney, Penrith, NSW, Australia. gordon.hendry@gcu.ac.uk.
authors: Gordon J
authors: GJ
authors: Hendry
authors: Kathryn A
authors: KA
authors: Gibson
authors: Kevin
authors: K
authors: Pile
authors: Luke
authors: L
authors: Taylor
authors: Verona
authors: V
authors: du Toit
authors: Joshua
authors: J
authors: Burns
authors: Keith
authors: K
authors: Rome
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