Orthotic Prescriptions for RA: What Podiatrists Use

Abstract

Background: Guidelines recommend foot orthoses for people with both early (< 2 years) and established rheumatoid arthritis (RA). While prefabricated foot orthoses are cheaper and can exhibit comparable effects to customised devices, the available evidence for their effectiveness is inconsistent. Little is known about what types of foot orthoses clinicians prescribe. This study describes the foot orthoses prescription habits of podiatrists for people with rheumatoid arthritis.

"This is a review of prescribing habits across podiatrists in the UK, AUS and NZ. Significantly more CFO v PFO were prescribed in AUS-(most responders were in private practice) compared to NZ and the UK (I question the data here- they report that a majority of respondents in NZ did NOT work in private or group practice- and I don't think this reflect the true distribution of podiatrists in NZ). It is nonetheless true that CFO are commonly used in AUS, and may be clinicians first choice in prescribing if cost and access barriers were removed. It is also evident in the data here that NZ practitioners precribe PFO very very widely and across many conditions/diagnoses. One may assume Formthotics make up a majority of these prescriptions."

- Dr Bob Eckles

Conclusions: Considerable variation was seen in the self-reported foot orthoses prescription habits of respondents for people with RA. Variation between countries and disease stage was seen in type of orthoses, specific brands, manufacturing methods, and materials prescribed. The results allow podiatrists and broader health service providers to compare their practice against reported national and international patterns.

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