RT Journal Article
SR Electronic
T1 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases
JF Annals of the Rheumatic Diseases
JO Ann Rheum Dis
FD BMJ Publishing Group Ltd and European League Against Rheumatism
SP 1260
OP 1267
DO 10.1136/ard-2023-224514
VO 83
IS 10
A1 Dures, Emma
A1 Farisoğulları, Bayram
A1 Santos, Eduardo José Ferreira
A1 Molto, Anna
A1 Feldthusen, Caroline
A1 Harris, Claire
A1 Elling-Audersch, Corinna
A1 Connolly, Deirdre
A1 Elefante, Elena
A1 Estévez-López, Fernando
A1 Bini, Ilaria
A1 Primdahl, Jette
A1 Hoeper, Kirsten
A1 Urban, Marie
A1 van de Laar, Mart A F J
A1 Redondo, Marta
A1 Böhm, Peter
A1 Amarnani, Raj
A1 Hayward, Rhys
A1 Geenen, Rinie
A1 Rednic, Simona
A1 Pettersson, Susanne
A1 Thomsen, Tanja
A1 Uhlig, Till
A1 Ritschl, Valentin
A1 Machado, Pedro M
YR 2024
UL http://ard.bmj.com/content/83/10/1260.abstract
AB Objectives Fatigue 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.Methods A 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.Results Four 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.Conclusions These 2023 EULAR recommendations provide consensus and up-to-date guidance on fatigue management in people with I-RMDs.