A RHEUMATOLOGY podiatry service trial will test feasibility of improving patient-centered foot outcomes in rheumatologic disorders.
Why A Rheumatology Podiatry Service Matters
Foot-specific symptoms are a frequent and disabling burden for people living with rheumatological conditions, affecting function, daily activities, and quality of life. The study authors highlight that foot and ankle symptoms can track with higher disease activity and disability, and that complications such as foot ulceration occur in chronic inflammatory disease, including but not limited to rheumatoid arthritis and other connective tissue disorders. Despite advances in treatment, including disease-modifying antirheumatic drugs, foot-specific symptoms may persist, reinforcing the need for targeted management strategies that reflect patient priorities.
Trial Design: Testing Feasibility Before a Definitive Study
This protocol describes a pragmatic, participant-blind, parallel-group, randomized feasibility trial that will compare access to a publicly funded podiatry service with usual care. Thirty adults with a rheumatological condition and foot specific symptoms will be recruited from an outpatient rheumatology clinic, then randomized to either the podiatry service or a control group receiving usual care. Outcomes will be collected at baseline, Week 6, and Week 12.
Feasibility will be assessed using a framework covering 10 key domains of uncertainty in pragmatic feasibility trials, with the intent of determining whether a fully powered randomized trial is practical and appropriately designed. Alongside feasibility metrics, the study will calculate effect sizes for between-group differences to signal potential efficacy and help inform future sample size estimates.
Patient-Centered Outcomes: Can Goal Attainment Scaling Work Here
A central aim is to test Goal Attainment Scaling as a potential primary outcome in this population. By incorporating patient-centered goal setting and measuring progress over time, the investigators aim to capture outcomes that align with what matters most to people experiencing foot-related symptoms, while also generating evidence to support a broader evaluation of effectiveness and cost-effectiveness in a later definitive trial.
Reference: Whittaker GA. Patient-centred outcomes of a rheumatology podiatry service for people with foot-specific symptoms: protocol for a randomised feasibility trial. Rheumatol Int. 2026;46(3):46.
