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Evaluating the Clinical Effectiveness and Cost-effectiveness of Foot Orthoses in the Treatment of Plantar Heel Pain

A Feasibility Study

Keith Rome, PhD, DPodM ^*, Joanne Gray, MSc ^*, Fiona Stewart, PhD , Stephen Charles Hannant, BSc(Hons), DPodM , Des Callaghan, MA, DPodM  and Joanne Hubble, BSc(Hons), DPodM 

^* School of Health and Social Care, University of Teesside, Middlesbrough, England.
North Tyneside Hospital North Shields, Newcastle, England.
Podiatry Services, North Tyneside Area Health Authority Trust, Newcastle, England.
Podiatry Services, Hartlepool Area Health Authority Trust, Hartlepool, England. Mr. Callaghan is now deceased.

Corresponding author: Keith Rome, PhD, DPodM, Teesside Centre for Rehabilitation Sciences, School of Health and Social Care, University of Teesside, Middlesbrough TS1 3BA, England.

Abstract

This study evaluated the clinical effectiveness and cost-effectiveness of two different types of foot orthoses used to treat plantar heel pain. Forty-eight patients were randomly assigned to receive either a functional or an accommodative orthosis. General (EuroQol) and specific (Foot Health Status Questionnaire) health-status measures were used. Data were also collected using economic questionnaires relating to National Health Service costs for podia-try, other health-service costs, and patient costs. Data were measured at baseline and at 4- and 8-week intervals. Thirty-five patients completed the study. The results demonstrated a significant decrease in foot pain and a significant increase in foot function with the functional foot orthoses over the 8-week trial. The accommodative foot orthoses demonstrated a significant reduction in foot pain only at 4 weeks. The cost-effectiveness analysis demonstrated that functional orthoses, although initially more expensive, result in a better quality of life. Use of functional orthoses resulted in an increased cost of £17.99 ($32.74) per patient, leading to an incremental cost per quality-adjusted life year of £1,650 ($3,003) for functional orthoses. (J Am Podiatr Med Assoc 94(3): 229–238, 2004)

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