2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice

Ritschl, Valentin; Stamm, Tanja; Aletaha, Daniel; Bijlsma, J. W. J.; Böhm, Peter; Drăgoi, Răzvan; Dures, Emma; Estévez‐López, Fernando; Gossec, Laure; Iagnocco, Annamaria; Marques, Andréa; Moholt, Ellen; Nudel, Michal; Bemt, Bart J F van den; Viktil, Kirsten K.; Voshaar, Marieke; Thurah, Annette de; Carmona, Loreto

doi:10.1136/annrheumdis-2020-218986

Cited by 35 publications

(37 citation statements)

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“…To account for this individuality, the interventions should be tailored to the patient’s needs. 80 In our results, 81 (72%) of the described face-to-face interventions showed such a tailored approach. However, only 7 out of 15 (47%) e-health programmes were tailored, which indicates a need for development of innovative tools and strategies to facilitate personalisation of these interventions.…”

Section: Discussionsupporting

confidence: 53%

Suitability for e-health of non-pharmacological interventions in connective tissue diseases: scoping review with a descriptive analysis

et al. 2021

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ObjectiveNon-pharmacological interventions support patients with connective tissue diseases to better cope with and self-manage their diseases. This study aimed to map existing evidence on non-pharmacological interventions in patients with systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and mixed connective tissue diseases regarding content, feasibility and potential suitability in an e-health setting.MethodsA literature search was performed in eight different databases in July 2020. The intervention’s content was extracted using the ‘Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide’. A Sankey diagram and descriptive statistics were used to analyse the data and illustrate the relationships between the interventions.ResultsOf 8198 identified records, 119 papers were eligible. One hundred and four of them (87.4%) were conducted between 2000 and 2020, mainly in the USA (SLE n=24 (21.2%), SSc n=16 (14.2%)), Brazil (SLE n=8 (7.1%), SSc n=5 (4.4%)) and Italy (SLE n=0 (0%), SSc n=12 (10.6%)). Fifty-two studies (SLE n=24 (21.2%), SSc n=28 (24.8%)) used multicomponent interventions. The single interventions were physical exercises (SLE n=16 (14.2%), SSc n=17 (15.0%)), coaching/counselling (SLE n=11 (18.0%), SSc n=0 (0%)) and education (SLE n=2 (1.8%), SSc n=3 (2.7%)). Primary outcomes focused on physical function (SLE n=1 (0.9%), SSc n=15 (13.3%)), mouth opening in SSc (n=4 (5.9%)) and physical capacity (SLE n=2 (1.8%), SSc n=1 (0.9%)). No interventions for mixed connective tissue disease were found.ConclusionThere was a great variety in the intervention’s content due to differences in body structure, activity limitations and participation restrictions in SLE and SSc. These results highlight the need for personalised, multicomponent, non-pharmacological interventions, which could be delivered as e-health interventions.

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Section: Discussionsupporting

confidence: 53%

Suitability for e-health of non-pharmacological interventions in connective tissue diseases: scoping review with a descriptive analysis

et al. 2021

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Section: Resultsmentioning

confidence: 99%

“…26 The taskforce considers treatment adherence (and discussions addressing this) to be part of the patient education plan. 31 Patient organisations reinforce the information and messaging about adherence and the impact of peer reinforcement around adherence is very powerful. EULAR has produced recommendations for patient education for people with IA addressing when and by whom patient education should be offered, as well as modes and methods of delivery, theoretical frameworks, outcomes and evaluation.…”

Section: Mean (Sd) % With Score ≥8mentioning

confidence: 99%

2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

et al. 2021

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BackgroundAn important but often insufficient aspect of care in people with inflammatory arthritis (IA) is empowering patients to acquire a good understanding of their disease and building their ability to deal effectively with the practical, physical and psychological impacts of it. Self-management skills can be helpful in this regard.ObjectivesTo develop recommendations for the implementation of self-management strategies in IA.MethodsA multidisciplinary taskforce of 18 members from 11 European countries was convened. A systematic review and other supportive information (survey of healthcare professionals (HCPs) and patient organisations) were used to formulate the recommendations.ResultsThree overarching principles and nine recommendations were formulated. These focused on empowering patients to become active partners of the team and to take a more proactive role. The importance of patient education and key self-management interventions such as problem solving, goal setting and cognitive behavioural therapy were highlighted. Role of patient organisations and HCPs in promoting and signposting patients to available resources has been highlighted through the promotion of physical activity, lifestyle advice, support with mental health aspects and ability to remain at work. Digital healthcare is essential in supporting and optimising self-management and the HCPs need to be aware of available resources to signpost patients.ConclusionThese recommendations support the inclusion of self-management advice and resources in the routine management of people with IA and aim to empower and support patients and encourage a more holistic, patient-centred approach to care which could result in improved patient experience of care and outcomes.

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“…31 Around 3 decades past the introduction of bDMARDs, the rheumatologic community has proposed concepts of patient empowerment and self-management alongside or integrated in patient-centered care. 16,28,32,33 Active and effective implementation of these concepts in daily routine care is already overdue and remains one of the greatest challenges. The goal elicitation tool by Kahler el al 23 is a step toward better patient-HCP communication, which is at the epicenter of shared decision making and, therefore, of the effective management of patients with RA.…”

Section: Editorialmentioning

confidence: 99%

Back to Basics: Prioritizing Communication as a Key Instrument in Managing Rheumatoid Arthritis

Studenic

Radner

2021

J Rheumatol

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2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice

Cited by 35 publications

References 50 publications

Suitability for e-health of non-pharmacological interventions in connective tissue diseases: scoping review with a descriptive analysis

Suitability for e-health of non-pharmacological interventions in connective tissue diseases: scoping review with a descriptive analysis

2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

Back to Basics: Prioritizing Communication as a Key Instrument in Managing Rheumatoid Arthritis

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