“I have taken five different kinds of tablets and injections, and I still have foot pain”: An international Outcome Measures in Rheumatology (OMERACT) qualitative interview study exploring patient perspectives of foot and ankle disorders
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All Authors
Chapman, Lara
Flurey, Caroline
Richards, Pamela
Redmond, Anthony
Soliman, Eiman
Moshrif, Abdelhfeez
Malone, Lucy
Joyce, Christopher
Arnold, John
Golightly, Yvonne
LTHT Author
Helliwell, Philip
Siddle, Heidi
Siddle, Heidi
LTHT Department
Podiatry
NIHR Leeds Biomedical Research Centre
NIHR Leeds Biomedical Research Centre
Non Medic
Consultant Podiatrist
Publication Date
2025-07-10
Item Type
Conference Abstract
Language
en
Subject
Subject Headings
Bitstream
Abstract
Background
The foot and ankle are frequently affected in rheumatic and musculoskeletal diseases (RMDs), yet there is a lack of high-quality evidence to determine the effectiveness of treatments (1). Outcome domains in foot and ankle research are often inconsistently measured, impeding evidence synthesis (2, 3). Additionally, clinical decisions are based on research outcomes, but these are not always regarded as important by patients (4).
Aim
This international qualitative study aimed to understand what domains matter to patients with a range of RMDs, who had sought treatment for foot and ankle disorders.
Methods
Patients were recruited through clinical departments and electronic mailing lists, and invited to participate in a single semi-structured interview. Transcripts were analysed using a mixed deductive/inductive approach to the framework method. Patient research partners co-produced the interview schedule and recruitment materials, and interpreted results.
Results
Fifty-six patients (36 female; age range 27-76) in eight countries (UK, Republic of Ireland, Malta, Serbia, Egypt, United States, Canada, Australia) participated. Participants had a variety of RMDs, including rheumatoid arthritis, spondyloarthropathies, juvenile idiopathic arthritis, osteoarthritis, crystal arthropathies and connective tissue diseases. Important domains (Table) included pain, physical function (reduced range of movement, stiffness, muscle weakness, joint instability, balance, altered gait), deformity, fatigue, skin/nail health, activities/participation, psychological impact, sleep, footwear impact and personal expenses. Domains were important to participants regardless of their RMD or geographic location. Most participants expressed dissatisfaction and uncertainty relating to treatments.
Conclusion
Foot and ankle disorders have far-reaching consequences for RMD patients, but are often inadequately treated. This large qualitative study provides a foundation for achieving international consensus on outcomes to be measured in all future clinical trials in this area. Standardising the measurement of outcomes that are meaningful to patients could improve evidence for foot and ankle treatments and facilitate translation of research findings into NHS clinical practice.