Patient-centred outcomes of a rheumatology podiatry service for people with foot-specific symptoms: protocol for a randomised feasibility trial

TL;DR

This study tests if a publicly-funded podiatry service improves outcomes for people with rheumatological foot symptoms.

Contribution

The study introduces a feasibility trial framework for evaluating a publicly-funded podiatry service in rheumatology care.

Findings

Thirty participants will be randomized to assess the feasibility of the podiatry service.

Feasibility will be evaluated using a framework with 10 domains of uncertainty.

Goal Attainment Scaling will be tested as a potential primary outcome measure.

Abstract

People with rheumatological conditions often experience debilitating foot-related symptoms requiring expert multidisciplinary care. However, in Australia there is a glaring gap in the provision of universally accessible, publicly-funded podiatry services. This study aims to assess the feasibility of a randomised trial evaluating a publicly-funded podiatry service for people with foot-specific symptoms related to rheumatological conditions. A pragmatic, participant-blind, parallel-group, randomised feasibility trial will compare effectiveness of a podiatry service with usual care. Consumer interviews will inform the design of the feasibility trial. Thirty adults with a rheumatological condition and foot specific symptoms will be recruited from an outpatient rheumatology clinic and randomised to receive access to a podiatry service or a control group who will receive usual care. Outcome measures will be obtained at baseline, week 6 and week 12. Feasibility will be evaluated using a framework that includes 10 important domains of uncertainty in pragmatic feasibility trials. Secondary outcomes (such as Goal Attainment Scaling) will also be collected and effect sizes of between group differences calculated to signal efficacy. The study will explore the feasibility of conducting a fully powered randomised trial of the effectiveness of a podiatry service for people with a rheumatological condition and foot-specific symptoms. In addition, the trial will determine the feasibility of Goal Attainment Scaling as a primary outcome measure for this population.

Trial registration.

The trial is registered with the Australian and New Zealand Clinical Trial Registry (ANZCTRN12625001000493 on the 9th of September 2025).

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