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01-12-2017 | Research | Uitgave 1/2017 Open Access

Journal of Foot and Ankle Research 1/2017

Experiences of mobility for people living with rheumatoid arthritis who are receiving biologic drug therapy: implications for podiatry services

Tijdschrift:
Journal of Foot and Ankle Research > Uitgave 1/2017
Auteurs:
Lucy Sanders, Margaret Donovan-Hall, Alan Borthwick, Catherine J. Bowen
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1186/​s13047-017-0195-4) contains supplementary material, which is available to authorized users.

Abstract

Background

Despite significant advancements in new treatment modalities for rheumatoid arthritis with biological therapies, foot complications remain a disabling and common feature of the disease. In this study the aim was to explore and describe the personal experiences of people with rheumatoid arthritis in receipt of biologic treatments in a bid to understand the impact of this form of medication on their mobility.

Methods

An interpretative phenomenological analysis (IPA) was undertaken to explore in depth the individual experience of rheumatoid disease through personal accounts of the patient journey spanning both ‘before’ and ‘after’ the instigation of biologic therapy. A purposive sampling strategy was adopted and in-depth semi structured interviews used to facilitate rich, detailed interview data exploring the lived experiences of individuals undertaking biological therapy and the changes to mobility experienced as a result. Thematic analysis was employed with an IPA framework to identify key meanings, and report patterns within the data.

Results

Five people with rheumatoid arthritis participated in the study. The mean disease duration was 20.2 years (range: 6 -32) and all were being treated with biologic therapies. Four key themes emerged from the data: 1) Life before biologic treatment, depicted in accounts as a negative experience characterised by painful and disabling symptoms and feelings of hopelessness. 2) Life with biologic treatment, often experienced as a life changing transition, restoring function and mobility and offering renewed hope. 3) Sense of self, in which the impact of rheumatoid disease and the subsequent changes arising from biologic therapy reveal a profound impact on feelings of personal identity both pre and post biologic therapy; an effect of footwear on self-image emerges as a dominant sub theme; 4) Unmet footcare needs were evident in the patient narrative, where the unrelenting if diminished impact of foot pain on mobility was viewed in the context of problematic access to foot health services.

Conclusion

Whilst the findings from this study mirror those within the existing literature, which report improvements in physical function related to biological therapy, foot problems clearly remained an unremitting feature of life for patients with rheumatoid disease, even when in receipt of biologics.

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Extra materiaal
Additional file 1: Topic guide for semi-structured interviews. (DOCX 13 kb)
13047_2017_195_MOESM1_ESM.docx
Additional file 2: Themes and sub-themes. (DOCX 13 kb)
13047_2017_195_MOESM2_ESM.docx
Literatuur
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