Health Professionals in Rheumatology Abstracts 1100 Parameter With Loading Dose (%) Without loading dose (%) Alopecia 3.6 5.1 Skin rash 4.9 3.1 Nausea/Anorexia 4.3 0 Diarrhoea 0.9 3.1 Chemical hepatitis 1.3 3.9 Hypertension 1.8 1.0 Herpes Zoster 0.5 0 Weight loss 2.2 0 Earlier study noted 4 patients of which 2 with serious skin rash and the other 2 patients with gross hepatitis all of which required Cholesteramine washout. Whereas washout was not required for any patient in this current study. Among the patients with skin rash, 2 had erythema multiforme and were given cholestyramine washout Conclusions: The mild side effects may be same with LEF with or without loading dose but serious adverse events may be more common with loading dose. It looks that depriving the loading dose for the patients may not reduce the side effects which are possibly due to LEF. References: 1. BykerkV.P. et al Canadian recommendations for the management of RA . J Rheum 2012;39:1559-15982. 2. ErraA. et al Is the recommended dose of LEF the best regimen to treat RA patients? ( L) Rheumatology2003; 42: 1123-1124. 3. MaddisonP. et al LEF in RA: Recommendations through a process of consensus. Rheumatology 2005;44:280-286. 4. Rao URK, Fatima F. LEF as an add on therapy in RA- Adverse events. EULAR 2004 Abstract FRI0120. Disclosure of Interest: None Declared AB0851-HPR IS SOCIAL MEDIA THE ANSWER TO THE SUPPORT DESIRED BY PEOPLE WITH RA? A QUALITATIVE EXPLORATION S. Otter1, S. Naidoo1, I. Haq2. 1School of Health Professions, University of Brighton, Eastbourne, 2Brighton & Sussex Mediocal School, University of Brighton, Brighton, United Kingdom Background: Social media (Facebook, Twitter LinkedIn and so on) are part of daily life for many with diverse roles ranging from entertainment, education and finance with increasing potential for sharing health information and providing support thus allowing users to create and link into networks of people with shared interests or experiences which may have an important role to play in patient centred care (Sarasohn-Kahn 2008). In contrast, outcomes in rheumatoid arthritis (RA) have too often been associated with, loss of mobility and reduced quality of life leading to loss of independence, anger, frustration and depression. Recent advances in pharmacological management have improved outcomes for many, but often add to the overall complexity of disease management for the individual. Objectives: We aimed to identify current use of social medial by people with RA and determine if this new technology could help develop a more patientcentred model of care. Methods: Semi-structured qualitative interviews were carried out with 14 people with RA to explore the lived experience of their disease, identify their current use of social media and specifically if and how they would like to see this technology used in their future care. Interviews were transcribed verbatim and a process of thematic analysis undertaken using N-Vivo software. Themes were subsequently agreed by the research team, prior to a process of respondent validation. Results: The overriding theme from respondents was one of ownership of their disease whereby social media can be used to provide a support mechanism over and above that which is already provided by visits to the multidisciplinary team. Interestingly at the point of diagnosis, respondents reported being overwhelmed by existing online resources. Therefore the desire for more patient-centred social media that could be developed specifically to be tailored by the individual was noted. These media could then be used to bring people with similar experiences who are geographically distant together in a meaningful way, for example through blogs or webinars, as well as being a source of reference for disease management and/or as a resource when attending appointments e.g. for tracking symptoms. Moreover, because of the hand pain and deformities experienced by respondents, the use of touchscreen technology (e.g. smartphones and tablets), were reported to be a much easier way of navigating health resources. Finally, the immediacy of support/ information that can be provided by social media is something respondents desired. Conclusions: The type of social media that people with RA would find most useful does not yet appear to exist. These data will be used to create the architecture of an application (‘app’) that people with RA and their family and friends as well as their clinicians can use to assist the monitoring and selfmanagement of their own health. References: Sarasohn-Kahn, J. 2008. The wisdom of patients: health care meets online social media. California Healthcare Foundation. Oakland, USA. [Online] Available at: http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/ PDF/H/PDF%20HealthCareSocialMedia.pdf Accessed: 01.07.2011 Acknowledgements: We would like to thank the National Rheumatoid Arthritis Society for assisting with recruitment and to the interview participants who gave up their time Disclosure of Interest: None Declared AB0852-HPR PEDOBAGRAPHIC MEASUREMENTS OF RHEUMATOID FEET AND COMPARISON WITH CLINICAL PARAMETERS Y. Yumusakhuylu1, A. Icagasioglu1, S. T. Turgut2, E. Selimoglu3, S. Murat1, E. K. Gunal4, B. Turgut5. 1Physical Therapy and Rehabilitation, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, 2 Physical Therapy and Rehabilitation, Karaman Government Hospital, Karaman, 3Physical Therapy and Rehabilitation, Siirt Kurtalan Government Hospital, Siirt, 4Rheumatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, 5Radiology, Karaman Government Hospital, Karaman, Turkey Background: Foot involvement in rheumatoid arthritis (RA) have been reported to be 56-100% in different studies. Pedobarography is used for dynamic plantar pressure measurement and to point out deformities of rheumatoid feet. Objectives: The aim of this study was to assess the use of pedobarographic measurements for the investigation of the relationship between plantar pressure alterations and disease activity, radiological changes and foot indexes in patients with RA. Methods: Patients over 18 years of age with rheumatoid arthritis experiencing foot pain were included. Data on patients sociodemographics, foot symptoms, anatomical distribution, intensity and duration of pain and access to podiatry services were collected using questionnaires completed during outpatient visit. For the functional status the scores of disease activity scale of 28 joints (DAS 28) and Health Assessment Questionnaire (HAQ) was used. Foot function index (FFI) and Manchester Foot Pain and Disability Index (MFPDI) were also administered to all RA patients. Modified Larsen scoring was used to asess radiological changes. Pedobarographic measurements was used to analyze foot loading characteristics. Results: A total of 104 feet of 52 RA patients (48 female, 4 male) with a mean age of 53,88±11,36 years was evaluated. DAS 28 scores did not correlate with the plantar pressure changes (p>0,05). We found a significant correlation between HAQ scores and right medial midfoot loading pressure (r=0,355; p<0,01). FFI scores were pozitively correlated with right lateral midfoot loading pressure (r=0,302; p<0,05). We did not found a relationship between MFPDI and plantar loading characteristics. The radiological scores were correlated with the left lateral hindfoot plantar pressure (r=0,286; p<0,05). Conclusions: Pedobarographic investigation of rheumatoid feet may provide a concept for treatment planning and rehabilitative care. References: 1. Tuna H, Birtane M, Taştekin N, Kokino S.Pedobarography and its relation to radiologic erosion scores in rheumatoid arthritis. Rheumatol Int. 2005 Nov;26(1):42-7. 2. Borman P, Ayhan F, Tuncay F, Sahin M. Foot problems in a group of patients with rheumatoid arthritis: an unmet need for foot care.Open Rheumatol J. 2012;6:290-5. Disclosure of Interest: None Declared Ann Rheum Dis: first published as 10.1136/annrheumdis-2013-eular.3174 on 23 January 2014. Downloaded from http://ard.bmj.com/ on 2 May 2018 by guest. Protected by copyright. observed more in the patients of RA when given leflunomide with loading dose (100mg/d for 3 days).It is considered that the side effects would be lesser when the patients are not given the loading dose of leflunomide. In our study we compared the side effect profile in two cohorts where in one was given loading dose the other did not Objectives: To evaluate the side effects observed in patients receiving LEF as an add on therapy with or without loading dose in RA Methods: Three hundred eighty seven patients with active RA without a loading dose of LEF(ARAVA) in combination with MTX were included. The indication to start LEF was suboptimal response to MTX. Hemogram, ESR/ CRP and LFT were measured both at entry and monthly for the first six months and every three months thereafter. LEF tolerability was closely monitored and adverse events were noted and followed up. A historic comparison was done with the study conducted at the same centre earlier between October 2001 and December 2003(Firdaus,Rao). Results: A total of 387 patients of which 332 women (85.7%) and 57 men (14.7%), with a mean age 49.7±10.71 yrs and drug dosage duration of 6 ± 4.2 yrs were included; 319 (82.4%) patients were seropositive.The side effect profiles were depicted in table -1 Table-1