Evaluación de la calidad de las guías de práctica clínica de artritis reumatoide con recomendaciones sobre la salud del pie

Introduction

Deformity and foot pain are almost omnipresent (90%) in rheumatoid arthritis (RA), due to the interaction between inflammation and abnormal biomechanical. Non-pharmacological interventions (insoles, footwear) have an important role but it is still a careless area. Clinical practice guidelines (CPG) have recommendations for patient care, reducing variability in clinical practice. There are several general CPG to treat patients with RA, but not for foot pathology. The aim of this work is to develop CPG meeting the demand of non-pharmacological treatment of foot pathology in patients with RA.

Method

Review of the scientific literature to identify all CPG of RA and foot, between 1975-2016. The instrument used to evaluate the CPG was the AGREE II.

Results

In relation to the overall quality, the best CPG is NICE CPG (score 6/7) and GUIPCAR and Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis CPG have the lowest score. In relation to the recommendations of the foot, not all CPG have them (Brazilian Society of Rheumatology Consensus for the treatment of rheumatoid arthritis CPG no) and those with more are the HAS and Guidelines for the management of the foot health problems associated with rheumatoid arthritis CPG.

Conclusion

In general, the best CPG in AR is NICE CPG. There are also three other recommended GPC: RACGP, SIGN and non-drug treatment (excluding surgery) in rheumatoid arthritis GPC.