A survey of rheumatology occupational therapy compression glove practice and provision in North-West England

Introduction & Aims: Compression gloves are provided to reduce hand pain and stiffness in rheumatoid arthritis (RA) and hand osteoarthritis (OA). We surveyed North West Region Rheumatology occupational therapists (NWRROTs) to investigate practice, wearing regimens, assessment methods and costs. Methods: Survey content was discussed, developed, reviewed and modified with help from NWRROTs. The survey was e-mailed to 35 NWRROTs. Results were analysed using SPSSv20 and content analysis Results: 22/35 OTs responded; 3 did not provide compression gloves and three joint replies (ie 17 questionnaires). OTs had average experience of: 14 years in Rheumatology; and 3-4 years providing gloves. OTs provided gloves to: 16-17 people with IA/RA or hand OA/month, i.e. 30% (IQR 10-50%) of their RA/hand OA OT caseload. Isotoner or Norco oedema ¾ length finger gloves were the commonest provided. Therapists used pain, range of movement, joint swelling and hand function, assessed through questions and observation, to evaluate glove effectiveness. 11 also used standardized measures including: hand oedema (Jobskin tapes, volumetry or ring sizer; n=11); pain (10 point rating scale) (n=10); grip (n=5); Disabilities Arm Shoulder Hand scale (n=5) and/or goniometry (n=4). OTs took 25 (SD 19.6) minutes to assess for, fit and instruct in glove use; 12 saw patients in person average 3 weeks later for 15 minutes to review and evaluate effectiveness; 8 conducted telephone reviews. Conclusion and relevance to practice: NWRROTs provide compression gloves to about a third of their patients with RA or hand OA. There is, however, limited published evidence for glove effectiveness in RA