Podiatry services for people with inflammatory arthritis managed using biological therapies
The introduction of biological therapies to manage inflammatory arthritis has been associated locally with an increased incidence of pedal wounds/infections being noted in this recipient group. However, only 43% of this group have accessed specialist podiatry services. The impact of pedal infection is serious and potentially life-threatening. Osteomyelitis can result in the therapy being withdrawn, with longer term implications to the individual and health services.
The department adopts a pro-active approach to foot-related problems in this patient group, aiming to address tissue viability and muscloskeletal problems related to underlying disease and its effects, as well as negative and positive aspects to biological therapies. A dedicated education/information programme, addressing tissue viability/infection issues within self management, has been introduced. During sessions, further patient need is often identified.
Patients can be directed to the sessions by any member of the rheumatology team. People are encouraged to attend at the time they start the biological therapy, although attendance at any time is appropriate. Supporting leaflet-based information is being developed. A community-based screening and dedicated clinic service for this patient group is being established, staffed by a podiatrist specialising in rheumatology practice. The service aims to identify factors that may put the individual’s foot health at risk and initiate an appropriate management strategy, coordinating future podiatry care as required. Additional patient support is available through the rheumatology practitioner helpline service and the specialist clinician.