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Table 9 Recommendations on communication and organisation of RA-related footcare

From: Multidisciplinary recommendations for diagnosis and treatment of foot problems in people with rheumatoid arthritis

  LoE Ref LoA
Regular consultation and shared decision-making between the patient and healthcare professional should be included in RA-related footcare and should be customised to the individual patient. 4b n/a 8.8 (5–10)
Individual shoe-advice to people with RA with foot problems is essential and should include information on fit, cosmetics, function, durability and correct use of the shoes. 4a/b [32, 33, 35] 9.4 (8–10)
Footcare in patients with RA should include patient education.* Patient education may consist of preventive and curative care.** *1 **4b * [68] **n/a 9.6 (7–10)
Patient education on preventive care for RA-related foot problems should contain information about i) the cause and course of RA and RA-related foot disease; ii) recognition of infection and increased disease activity (systemic and local); iii) footcare and hygiene; iv) recognition and use of adequate footwear (for indoors and outdoors); v) timely consultation by a healthcare professional in the case of foot infection, symptoms of increased disease activity, pain, problems finding adequate footwear, and skin and nail conditions; and vi) the healthcare professional who may be consulted for a specific indication. 4a [11, 32, 33, 35] 9.3 (8–10)
Patient education on curative care for RA-related foot problems should contain information about i) the treatment strategy (short and long term); ii) the importance of treatment adherence and compliance; iii) the expected treatment results according to pain, physical functioning, activities, and participation; iv) the possible adverse events; and v) costs and reimbursement of the treatment. 4a [33, 35, 39, 51, 69] 9.2 (7–10)
A multidisciplinary approach in management of RA-related foot problems is recommended. The diagnosis and treatment of RA-related foot disease consists of different aspects, which require the expertise of several disciplines. 4a/b [11, 32] 9.6 (8–10)
  1. LoE Level of Evidence for the recommendations: (1) research of level A1 or at least 2 independently conducted studies of level A2, (2) 1 study of level A2 or at least 2 independently conducted studies of level B, (3) 1 study of level B or C, (4a) expert opinion described in the literature, (4b) opinion of the expert group. Ref.references. LoA Level of Agreement for the recommendations: Numeric Rating Scale from 0 (total disagreement) to 10 (total agreement) reported as mean (range). n/a not applicable. * refers to the first part of the recommendation with corresponding level of agreement and references. ** refers to the second part of the recommendation with corresponding level of agreement and references