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Background: Arthritis (compression) gloves are frequently provided to people with inflammatory (IA) or rheumatoid arthritis (RA) in the NHS, to help reduce swelling and alleviate hand pain by providing compression and improving circulation. However evidence for their effectiveness is limited.[1]\ud \ud \ud Objectives: Nested within a randomised controlled trial (RCT) testing the effectiveness of intervention (compression) gloves with control gloves (fitted at least one size too big) in people with RA and IA, this qualitative study aimed to explore patients’ perspectives on the effect of the arthritis gloves on their hand pain and function.\ud \ud \ud Methods: Once randomised, participants were provided joint protection and hand exercise booklets and fitted with either the intervention or the control glove(s) by a trained occupational therapist.[2] Both gloves had similar thermal qualities but control gloves did not apply compression. Semi-structured interviews were conducted with 10 participants, purposively selected from each group (n=20) following 12 weeks of glove wear. Interviews were audio-recorded, transcribed and analysed by three researchers using thematic analysis with a critical realist perspective.\ud \ud \ud Results: Participants’ perspectives on the effects of the arthritis gloves had three emergent sub-themes. These were:\ud \ud Usage: both groups predominantly used the gloves for activities such as wearing them outdoors to keep hands warm, night-time wear to help with sleep, and doing light domestic activities (e.g. dusting). Gloves were not used for cooking or washing-up or for personal activities of daily living (e.g. toileting, grooming) “What didn’t help as such, obviously was with washing etc. and toileting because I had to keep taking them off and putting them back on again”;\ud Symptomatology: while some reported that gloves helped to keep their “hand pain in check” others said that gloves had no effect on their hand pain or that they’d found “it’s made them worse”. Participants from both groups frequently mentioned the warmth element of the gloves, as a positive attribute to help with their symptoms;\ud Aesthetics: participants had opposing views on the appearance of the arthritis gloves. Some felt that the intervention gloves “look a bit ugly with the seams outside” or stated that they “would not want to wear that colour” but did not think they were obtrusive. Most noticeably, patients seemed to view the arthritis gloves as ordinary everyday gloves, rather than a medical device “if it was cold I wore them outside”.\ud \ud Conclusions: Trial participants reported experiencing similar effects from wearing either the intervention or control gloves, with varied perspectives on whether or not gloves affected hand pain and/or function. Overall, patients did not reflect on the compressive but rather the thermal qualities of the gloves, as warmth was the main effect perceived.\ud \ud \ud References:\ud Hammond, et al. Clin Rehabil 2016 30:213–24\ud Prior, et al. Rheum 2017(Supp1)\ud Acknowledgements: This project was funded by the NIHR Research for Patient Benefit Programme (PB-PG-0214–33010). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Background: Arthritis gloves are provided by NHS rheumatology occupational therapists (OTs) to people with inflammatory arthritis (IA) to reduce hand pain and stiffness and improve hand function. However, there is little evidence to support their effectiveness or efficacy. We are conducting a NIHR Research for Patient Benefit (PB-PG-0214-33010) funded multi-centre national randomized controlled trial (RCT) testing the efficacy of arthritis gloves in people with IA. Twenty-seven Rheumatology OTs from (Band 6) from 17 NHS Trusts across the UK are treating trial participants. As part of their trial training, we explored OTs’ views about contributing to the RCT, to identify any concerns and ongoing training needs in trial delivery. Methods: Three focus groups (FGs), using a semi-structured interview schedule were conducted. The Rheumatology OTs collaborating in the trial attended a one-day clinical trial training programme which included trial background, key study procedures and practize providing the intervention and placebo gloves in a standardized manner using the OT Glove Provision Manual. Informed written consent was obtained from all participants and FGs were audio recorded, transcribed verbatim and analysed by two researchers independently using Thematic Analysis to increase the confirmability of the findings. Results: The main challenges identified by OTs were themed around Personal, Service and Research Methodology Factors. Personal Factors included: trepidations about being involved in a RCT; and concerns around delivering a placebo treatment to patients with hand pain and stiffness. Service Factors included: being able to recruit to target within service constraints; receiving support from their consultants and research staff; and whether they could treat participants within the given time frame. Research Methodology Factors included: risk of introducing bias when delivering a placebo treatment, due to concerns about going against participants’ best interests, or lack of experience addressing participants’ queries without revealing treatment allocation. However, they also perceived opportunities from being involved in a multi-centred RCT. These were Professional Development and evidence-based practice opportunities such as; potential to improve relationships within their multi-disciplinary teams, widen their professional networks, and raise the profile of OT by contributing to evidence-based practice. Most OTs acknowledged that their trepidations were related to inexperience and expected to become more confident following training, familiarization with study protocols and delivery of their first placebo treatment. Conclusion: This trial is one of the few UK-funded placebo-controlled trials examining the clinical efficacy of OT intervention in rheumatology services. This introduces new issues for clinicians in knowingly delivering placebo interventions as part of a RCT. Our OTs identify personal, service and research factors that cause them trepidation in taking part but also recognize clear professional development opportunities in contributing to evidence-based practice