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

Abstract

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.

TELERA—Asynchronous TELEmedicine for Patients With Rheumatoid Arthritis: Study Protocol for a Prospective, Multi-Center, Randomized Controlled Trial

“…However, we could demonstrate that the majority of patients and rheumatologists agreed that patients in remission do not need to be seen in person ( 26 ). The recently published EULAR guidelines highlight the importance of self-management skills and potential of mobile apps to improve the clinical care of people with RA ( 27 ). Importantly, Thurah et al could previously demonstrate in a RCT that a remote care approach was safe and not inferior to conventional management in RA ( 28 ).…”

Empowering Patients in the Therapeutic Decision-Making Process: A Glance Into Behçet's Syndrome

“…Other skills that patients should learn and improve for an efficient self-management approach were also previously identified ( 39 , 40 ); some examples are offered by patient education, active involvement in problem solving/goal setting/decision-making, active interaction with significant others (healthcare professionals, family, patients' organizations), medication management, enhancing resource utilization (community, digital healthcare etc. ), improving stress management (also cognitive behavior therapy, if needed), healthy behaviors (e.g., regular physical activity, diet, body weight control, quitting smoking) and managing work duties.…”

“…- Enabling factors are mainly represented by problem solving skills and access to healthcare information, both digital and not digital ( 39 – 41 ).…”

“…According to this work, self-management is inspired by two key themes: to achieve independence of the patient, the former, and the idea that self-management should be supported by others (e.g., family, patients organizations, healthcare professionals), the latter. Therefore, it becomes clear how EULAR found an integration between self-management and self-management support ( 39 ).…”

Monitoring and Managing Cardiovascular Risk in Immune Mediated Inflammatory Diseases

“… 75 , 76 Additional benefits of systematic exercise include improvement in psychological well-being, 77 which may be severely affected in patients with IMIDs. 78 For these reasons, the importance of physical activity has been greatly emphasized by EULAR not only in the 2015/2016 updated recommendations for CVD risk management in patients with RA and other forms of inflammatory joint disorders, 79 but also in the recent 2021 recommendations for the implementation of self-management strategies in patients with inflammatory arthritis, as an effective, feasible and safe tool for managing common comorbidities.…”