scholarly journals Clinical effectiveness and cost-effectiveness of foot orthoses for people with established rheumatoid arthritis: an exploratory clinical trial

2016 ◽  
Vol 46 (3) ◽  
pp. 187-193 ◽  
Author(s):  
K Rome ◽  
H Clark ◽  
J Gray ◽  
P McMeekin ◽  
M Plant ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Cost Effectiveness ◽  
Clinical Effectiveness ◽  
Foot Orthoses ◽  
Established Rheumatoid Arthritis

scholarly journals FRI0612-HPR EFFECT OF THERMOFORMABLE ORTHOSES ON FOOT FUNCTION IN RHEUMATOID ARTHRITIS PATIENTS: PRELIMINARY RESULTS FROM AN OPEN CLINICAL TRIAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 911.2-912
Author(s):  
I. Aachari ◽  
H. Rkain ◽  
F. Safaa ◽  
L. Benzakour ◽  
T. Latifa ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Small Sample ◽  
Activity Limitation ◽  
Foot Orthoses ◽  
Functional Impact ◽  
Pain Disability ◽  
Before And After ◽  
Foot Function ◽  
The Impact

Background:Orthoses and footwear can play an important role in managing foot pathology in patients whose systemic disease is controlled. Foot orthoses are frequently prescribed in clinical practice as an intervention for people with rheumatoid arthritis (RA).Objectives:The aim of our study is to evaluate the impact of thermoformable orthoses on the functional index of the foot (FFI) in patients with rheumatoid arthritis.Methods:We conducted an open clinical trial, having consecutively included 14 patients (85.7% female, average age 54.8 ± 10 years) suffering from rheumatoid arthritis (median progression time of 9 years [5 - 12]). The average DAS28 was 2.7 ± 1.2 and the functional impact objectified by the Health Assessment Questionnaire (HAQ) was on average 0.9 ± 0.7.The median deadline from the start of RA and the onset of the foot problem was 3 years [0 – 7,75]. The foot problem was bilateral in 100% of the cases and inaugural in 85.7% of the cases.We evaluated the functional impact of foot injury for all our patients at baseline and 8 weeks after the use of thermoformable orthoses, based on the FFI (Foot function Index) measuring the impact of foot pathology on function in terms of pain, disability and activity limitation.The comparison of the FFI domains before and after the use of orthoses was carried out using parametric or nonparametric paired tests using The SPSS statistical software.Results:With the use of foot orthoses, FFI values decreased in all subscales (p=0,024) (pain, disability and activity limitation). This reduction was significant for disability (0,011) but not for pain and activity limitation.There were no significant correlations between the global FFI and the progression of RA, the duration of foot damage and the functional impact measured by the HAQ.Table 1. The comparison of the FFI domains before and after the use of orthoses.psignificatif if< 0,05; Test used: Non-parametric test for two linked samples.Conclusion:Foot orthoses were effective as an adjuvant in the management of rheumatoid foot. They significantly reduced disability as measured by the FFI. The absence of factors associated with pain and limitation of activity could possibly be related to the small sample size.Disclosure of Interests:None declared

scholarly journals The clinical effectiveness of intensive management in moderate established rheumatoid arthritis: The titrate trial

2020 ◽  
Vol 50 (5) ◽  
pp. 1182-1190
Author(s):  
David Scott ◽  
Fowzia Ibrahim ◽  
Harry Hill ◽  
Brian Tom ◽  
Louise Prothero ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Effectiveness ◽  
Intensive Management ◽  
Established Rheumatoid Arthritis

Can Foot Orthoses Prevent Hallux Valgus Deformity in Rheumatoid Arthritis? A Randomized Clinical Trial

1995 ◽  
Vol 1 (6) ◽  
pp. 313-322 ◽  
Author(s):  
Elly Budiman-Mak ◽  
Kendon J. Conrad ◽  
Kathryn E. Roach ◽  
James W. Moore ◽  
Yongsuk Lertratanakul ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Hallux Valgus ◽  
Valgus Deformity ◽  
Foot Orthoses ◽  
Hallux Valgus Deformity

Cost-effectiveness of etanercept treatment in early active rheumatoid arthritis followed by dose adjustment

2011 ◽  
Vol 27 (3) ◽  
pp. 193-200 ◽  
Author(s):  
Gisela Kobelt ◽  
Ingrid Lekander ◽  
Andrea Lang ◽  
Bernd Raffeiner ◽  
Costantino Botsios ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Cost Effectiveness ◽  
Disease Activity ◽  
Dose Reduction ◽  
Societal Perspective ◽  
Active Rheumatoid Arthritis ◽  
Biologic Treatment ◽  
Early Ra ◽  
The Cost

Objectives: To explore the cost-effectiveness of early biologic treatment, followed by dose-reduction in the case of remission, of active rheumatoid arthritis (RA), compared with standard treatment with methotrexate (MTX) in Sweden.Methods: Effectiveness (function, disease activity, erosions) in early RA for both alternatives was taken from a clinical trial comparing etanercept (ETA) combined with MTX to MTX alone. Patients discontinuing treatment can switch to another or their first biologic treatment. For patients in remission (Disease Activity Score [DAS28] < 2.6), ETA is reduced to half the dose. Return to full dose occurs when DAS28 reaches ≥ 3.2 again. Costs and utilities by level of functional capacity from an observational study are used. The model is analyzed as a micro-simulation and results are presented from the societal perspective for Sweden, for 10 years; costs (€2008) and effects are discounted at 3 percent. Sensitivity analysis was performed for the perspective, the time horizon, switching, and dose-reduction.Results: The main analysis conservatively assumes 50 percent switching at discontinuation. The cost per quality-adjusted life-year (QALY) gained with early ETA/MTX treatment is €13,500 (societal perspective, incremental cost of €15,500 and incremental QALYs of 1.15). With 75 percent switching, the cost per QALY gained was €10,400. Over 20 years, the cost per QALY gained was €8,200. Results were further sensitive to the time patients remained on half dose and the perspective.Conclusions and Policy Implications: This study combines clinical trial and clinical practice data to explore cost-effective treatment scenarios in early RA, including the use of biologics. Our results indicate that a situation where a considerable proportion of patients achieve remission, dose-adjustments will increase the cost-effectiveness of treatment.

scholarly journals FRI0686 The effect of foot orthoses on balance in rheumatoid arthritis patients: a randomized clinical trial

2018 ◽  
Author(s):  
J. Z. Gaino ◽  
M. B. Bertolo ◽  
C. S. Nunes ◽  
C. M. Barbosa ◽  
Z. Sachetto ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Foot Orthoses

Cost-effectiveness of clinical remission by treat to target strategy in established rheumatoid arthritis: results of the CREATE registry

2016 ◽  
Vol 36 (12) ◽  
pp. 1627-1632 ◽  
Author(s):  
M. Cárdenas ◽  
S. de la Fuente ◽  
M. C. Castro-Villegas ◽  
M. Romero-Gómez ◽  
D. Ruiz-Vílchez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cost Effectiveness ◽  
Clinical Remission ◽  
Treat To Target ◽  
Established Rheumatoid Arthritis ◽  
Target Strategy

Evaluating the Clinical Effectiveness and Cost-effectiveness of Foot Orthoses in the Treatment of Plantar Heel Pain

2004 ◽  
Vol 94 (3) ◽  
pp. 229-238 ◽  
Author(s):  
Keith Rome ◽  
Joanne Gray ◽  
Fiona Stewart ◽  
Stephen Charles Hannant ◽  
Des Callaghan ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Status ◽  
Health Service ◽  
Clinical Effectiveness ◽  
Heel Pain ◽  
Foot Orthoses ◽  
Foot Pain ◽  
Foot Health ◽  
Plantar Heel Pain ◽  
Health Service Costs

This study evaluated the clinical effectiveness and cost-effectiveness of two different types of foot orthoses used to treat plantar heel pain. Forty-eight patients were randomly assigned to receive either a functional or an accommodative orthosis. General (EuroQol) and specific (Foot Health Status Questionnaire) health-status measures were used. Data were also collected using economic questionnaires relating to National Health Service costs for podia-try, other health-service costs, and patient costs. Data were measured at baseline and at 4- and 8-week intervals. Thirty-five patients completed the study. The results demonstrated a significant decrease in foot pain and a significant increase in foot function with the functional foot orthoses over the 8-week trial. The accommodative foot orthoses demonstrated a significant reduction in foot pain only at 4 weeks. The cost-effectiveness analysis demonstrated that functional orthoses, although initially more expensive, result in a better quality of life. Use of functional orthoses resulted in an increased cost of £17.99 ($32.74) per patient, leading to an incremental cost per quality-adjusted life year of £1,650 ($3,003) for functional orthoses. (J Am Podiatr Med Assoc 94(3): 229–238, 2004)

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