The Clinical and Cost-effectiveness of Foot Orthoses in People With Established Rheumatoid Arthritis: An Exploratory Clinical Trial

aut.researcherRome, Keith
dc.contributor.authorRome, Ken_NZ
dc.contributor.authorGray, Jen_NZ
dc.contributor.authorMcKeekin, Jen_NZ
dc.contributor.authorPlant, Men_NZ
dc.contributor.authorClarke, Hen_NZ
dc.contributor.authorDixon, Jen_NZ
dc.date.accessioned2017-02-01T22:19:52Z
dc.date.available2017-02-01T22:19:52Z
dc.date.copyright2016-06-29en_NZ
dc.date.issued2016-06-29en_NZ
dc.description.abstractObjectives: Foot orthoses are commonly prescribed as an intervention for people with rheumatoid arthritis (RA). Data relating to the cost-effectiveness of foot orthoses in people with RA are limited. The aim was to evaluate the clinical and cost-effectiveness of two types of foot orthoses in people with established RA. Method: A single-blind randomized controlled trial was undertaken to compare custom-made foot orthoses (CMFOs) and simple insoles (SIs) in 41 people with established RA. The Foot Function Index (FFI) was used to measure foot pain, disability, and functional limitation. Costs were estimated from the perspective of the UK National Health Service (NHS), societal (patient and family) perspective, and secondary care resource use in terms of the intervention and staff time. Effects were assessed in terms of health gain expressed as quality-adjusted life years (QALYs). Results: At baseline, 20 participants received a CMFO and 21 participants received an SI. After 16 weeks foot pain improved in both the CMFOs (p = 0.000) and the SIs (p < 0.01). However, disability scores improved for CMFOs (p < 0.001) but not for SIs (p = 0.40). The cost-effectiveness results demonstrated no difference in cost between the arms (CMFOs: £159.10; SIs: £79.10; p = 0.35), with the CMFOs being less effective in terms of cost per QALY gain (p < 0.001). Conclusions: In people with established RA, semi-rigid customized foot orthoses can improve pain and disability scores in comparison to simple insoles. From a cost-effectiveness perspective, the customized foot orthoses were far more expensive to manufacture, with no significant cost per QALY gain.
dc.identifier.citationScandinavian Journal of Rheumatology, DOI: 10.1080/03009742.2016.1196500en_NZ
dc.identifier.doi10.1080/03009742.2016.1196500
dc.identifier.urihttps://hdl.handle.net/10292/10305
dc.publisherTaylor & Francis
dc.rightsCopyright © 2016 Taylor & Francis. This is a preprint of an article whose final and definitive form has been published in the Scandinavian Journal of Rheumatology and is available online at: www.tandfonline.com with the open URL of your article (see Publisher’s Version).
dc.rights.accessrightsOpenAccessen_NZ
dc.titleThe Clinical and Cost-effectiveness of Foot Orthoses in People With Established Rheumatoid Arthritis: An Exploratory Clinical Trialen_NZ
dc.typeJournal Article
pubs.elements-id206895
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
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