Article Text
Abstract
Objectives A European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs).
Methods Six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed.
Results Five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations.
Conclusions These recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans.
- smoking
- patient reported outcome measures
- arthritis
- epidemiology
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Supplementary materials
Lay summary
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Footnotes
Handling editor Josef S Smolen
Twitter @james_gwinnutt, @MoeRikke
Contributors JMG, MW, FG and SMMV contributed equally. SMMV conceived the idea and submitted the project with a contribution from FG to the EULAR executive committee. JMG and MW were the research fellows on the project who carried out the systematic literature reviews, with the help of PP, Maxime Ransay and EMEUNET members GC and JRC. These reviews were overseen by FG (methodologist) and SMMV (convenor). SMMV organised and chaired the telephone and face-to-face meetings. All authors contributed to the drafting of recommendations at the telephone and face-to-face meetings and helped to revise the recommendations manuscript.
Funding SMMV and JMG are supported by Versus Arthritis (21755) and the NIHR Manchester Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. JRC is supported by the Juan de la Cierva (IJCI-2017-32070) and Sara Borrell (CD19/00120) programs. The taskforce would like to thank EULAR for providing financial support for this project.
Competing interests None declared.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.