Fatigue in inflammatory arthritis

Dures, Emma; Cramp, Fiona; Hackett, Kate; Primdahl, Jette

doi:10.1016/j.berh.2020.101526

Cited by 16 publications

(12 citation statements)

References 119 publications

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“…This sense of on-going support was mentioned by participants interested in group work and sharing experiences with other patients. A buddying system could help to transition participants from the structured environment of the LIFT study to real-world exercise routines post-intervention [ 27 , 28 ]. Another model of interest is the co-production of peer support groups after pain management programmes.…”

Section: Discussionmentioning

confidence: 99%

Remotely delivered cognitive-behavioural and personalized exercise interventions to lessen the impact of fatigue: a qualitative evaluation

Bennett

Almeida

Bachmair

et al. 2022

Rheumatology Advances in Practice

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Objectives Fatigue can be a disabling symptom of inflammatory rheumatic diseases (IRD). LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) is a randomised trial of remotely delivered cognitive-behavioural approach (CBA) or personalised exercise programme (PEP) interventions, compared with usual care. The aim of this nested qualitative study was to evaluate participants’ experiences of taking part in the intervention, including their ideas about future service delivery. Methods Semi-structured telephone interviews with a subgroup of LIFT participants to discuss their views and experiences of the interventions. Results Forty-three participants (30 women) from six sites who had participated in CBA (n = 22) or PEP (n = 21) interventions took part. Five themes were identified in the thematic analysis: In ‘Not a miracle cure, but a way to better manage fatigue’, LIFT could not cure fatigue, however, most felt better able to manage after participating. Participants valued ‘Building a therapeutic relationship’ with the same therapist throughout the intervention. In ‘Structure, self-monitoring and being accountable’, participants liked the inclusion of goal setting techniques, and were motivated by reporting back to the therapist. After taking part in the interventions, participants felt ‘Better equipped to cope with fatigue’; more confident and empowered. Lastly, participants shared ideas for ‘A tailored programme delivered remotely’, including follow-up sessions; video calling; and group-based sessions for social support. Conclusion Many participants engaged with the LIFT interventions and reported benefits of taking part. This suggests an important future role for the remote delivery of fatigue self-management. Lay summary What does this research mean for patients? Fatigue can be a disabling symptom in inflammatory rheumatic diseases (IRDs). The LIFT Study (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomised Trial) looked at different interventions; a cognitive-behavioural approach (CBA), Personalised Exercise Programme (PEP), or usual care. CBA sessions addressed unhelpful thoughts and feelings. The PEP sessions supported people with IRDs to gradually increase their exercise levels. People with IRDs were randomly selected to take part in seven sessions of CBA, seven sessions of PEP, or usual care. All sessions except the first PEP session were delivered remotely by phone. The aim of this study was to explore people’s experiences of taking part. Forty-three people with IRDs (30 women, 13 men) were interviewed from six UK locations. Twenty-two took part in the CBA sessions, and twenty-one took part in PEP. People with IRDs who took part in LIFT told us about a range of benefits. These included feeling less fatigue and more confidence. Those in PEP told us they felt stronger. People with IRDs shared that they liked being able to talk about their fatigue with a supportive therapist. These are encouraging results for remotely-delivered research to support people with fatigue.

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Section: Discussionmentioning

confidence: 99%

Remotely delivered cognitive-behavioural and personalized exercise interventions to lessen the impact of fatigue: a qualitative evaluation

Bennett

Almeida

Bachmair

et al. 2022

Rheumatology Advances in Practice

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“…Fatigue is reported as one of the most demanding symptoms of inflammatory arthritis (IA) (Dures et al., 2020; Pilgaard et al., 2019). It is a multidimensional symptom effecting physical, cognitive, emotional, and social functioning of individuals with IA (Geenen & Dures, 2019; Murphy et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Testing the feasibility and acceptability of an online ‘Fatigue and Activity Management Education for Work (FAME‐W) programme’ for individuals with inflammatory arthritis

Karkon

O’Shea

Doran

et al. 2023

Musculoskeletal Care

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IntroductionFatigue and Activity Management Education for Work (FAME‐W) is a four‐week, occupational therapy led programme focussing on fatigue management strategies. FAME‐W was designed to be delivered in person; however, due to COVID‐19 pandemic it was modified to be an online group‐based self‐management intervention. The purpose of this study was to test the feasibility and acceptability of the online delivery format of FAME‐W.MethodsThis was a mixed methods study. Participants were randomly allocated to intervention or control group. Participants in the intervention group received a four‐week online FAME‐W. The control group participants received a FAME‐W handbook. Participants were required to complete questionnaires on work presenteeism, fatigue, mood, Health Related Quality of Life and pain at baseline, and 3 months post‐intervention. Participants in the intervention group attended a focus group immediately following the completion of the programme and the control group participated in individual interviews.ResultsSeven of ten individuals recruited participated in the study. Majority of participants had Rheumatoid Arthritis and were working full‐time. The mean age of intervention participants was 53 ± 10.4 and 56.5 ± 3.7 for the controls. All participants in the intervention group had 100% attendance, completed all study measures and activities. Participants had positive comments about the programme format, content, and delivery. Improvements were observed in most measures at follow up.ConclusionResults suggest that an online programme to improve work ability was feasible and acceptable to individuals with inflammatory arthritis. The online delivery format was favoured over attending a centre‐based programme. The findings support a definitive intervention trial of online FAME‐W.

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“…Inflammatory rheumatic and musculoskeletal diseases (I-RMDs) encompass several long-term conditions, including rheumatoid arthritis (RA), psoriatic arthritis, axial spondyloarthritis, systemic lupus erythematosus and Sjögren’s syndrome, among others. Fatigue is prevalent in people with I-RMDs and is one of the most challenging symptoms to cope with due to its invisible, pervasive and unpredictable nature 1–4. Although there is no single conceptualisation or definition of fatigue, it is recognised that fatigue in I-RMDs is different to normal feelings of tiredness 5.…”

Section: Introductionmentioning

confidence: 99%

2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases

Dures,

Farisoğulları,

Santos

et al. 2023

Ann Rheum Dis

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ObjectivesFatigue is prevalent in people with inflammatory rheumatic and musculoskeletal diseases (I-RMDs) and recognised as one of the most challenging symptoms to manage. The existence of multiple factors associated with driving and maintaining fatigue, and the evidence about what improves fatigue has led to a multifaceted approach to its management. However, there are no recommendations for fatigue management in people with I-RMDs. This lack of guidance is challenging for those living with fatigue and health professionals delivering clinical care. Therefore, our aim was to develop EULAR recommendations for the management of fatigue in people with I-RMDs.MethodsA multidisciplinary taskforce comprising 26 members from 14 European countries was convened, and two systematic reviews were conducted. The taskforce developed the recommendations based on the systematic review of evidence supplemented with taskforce members’ experience of fatigue in I-RMDs.ResultsFour overarching principles (OAPs) and four recommendations were developed. OAPs include health professionals’ awareness that fatigue encompasses multiple biological, psychological and social factors which should inform clinical care. Fatigue should be monitored and assessed, and people with I-RMDs should be offered management options. Recommendations include offering tailored physical activity and/or tailored psychoeducational interventions and/or, if clinically indicated, immunomodulatory treatment initiation or change. Patient-centred fatigue management should consider the individual’s needs and preferences, their clinical disease activity, comorbidities and other psychosocial and contextual factors through shared decision-making.ConclusionsThese 2023 EULAR recommendations provide consensus and up-to-date guidance on fatigue management in people with I-RMDs.

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Fatigue in inflammatory arthritis

Cited by 16 publications

References 119 publications

Remotely delivered cognitive-behavioural and personalized exercise interventions to lessen the impact of fatigue: a qualitative evaluation

Remotely delivered cognitive-behavioural and personalized exercise interventions to lessen the impact of fatigue: a qualitative evaluation

Testing the feasibility and acceptability of an online ‘Fatigue and Activity Management Education for Work (FAME‐W) programme’ for individuals with inflammatory arthritis

2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases

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