The effects of arthritis gloves on people with Rheumatoid Arthritis or Inflammatory Arthritis with hand pain: a study protocol for a multi-centred randomised controlled trial (the A-GLOVES trial)

Abstract

Background: Arthritis gloves are regularly provided as part of the management of people with rheumatoid arthritis (RA) and undifferentiated (early) inflammatory arthritis (IA). Usually made of nylon and elastane (i.e. Lycra®), these arthritis gloves apply pressure with the aims of relieving hand pain, stiffness and improving hand function. However, a systematic review identified little evidence supporting their use. We therefore designed a trial to compare the effectiveness of the commonest type of arthritis glove provided in the United Kingdom (Isotoner gloves) (intervention) with placebo (control) gloves (i.e. larger arthritis gloves providing similar warmth to the intervention gloves but minimal pressure only) in people with these conditions.
Methods: Participants aged 18 years and over with RA or IA and persistent hand pain will be recruited from National
Health Service Trusts in the United Kingdom. Following consent, participants will complete a questionnaire booklet, then
be randomly allocated to receive intervention or placebo arthritis gloves. Within three weeks, they will be fitted with the
allocated gloves by clinical specialist rheumatology occupational therapists. Twelve weeks (i.e. the primary endpoint) after
completing the baseline questionnaire, participants will complete a second questionnaire, including the same measures
plus additional questions to explore adherence, benefits and problems with glove-wear. A sub-sample of participants
from each group will be interviewed at the end of their participation to explore their views of the gloves received. The
clinical effectiveness and cost-effectiveness of the intervention, compared to placebo gloves, will be evaluated over
12 weeks. The primary outcome measure is hand pain during activity. Qualitative interviews will be thematically analysed.
Discussion: This study will evaluate the commonest type of arthritis glove (Isotoner) provided in the NHS (i.e. the
intervention) compared to a placebo glove. The results will help occupational therapists, occupational therapy services
and people with arthritis make informed choices as to the value of arthritis gloves. If effective, arthritis gloves should
become more widely available in the NHS to help people with RA and IA manage hand symptoms and improve
performance of daily activities, work and leisure. If not, services can determine whether to cease supplying these to
reduce service costs