Level of evidence* | Strength of recommendation | Level of agreement Mean (SD) Median (range) | |
Overarching principles | |||
A. Effective communication skills and a biopsychosocial approach in the assessment, treatment and care of people with RMDs are of paramount importance for HPRs | QLIb | NA | 9.79 (0.71) 10 (7–10) |
B. Person-centred care and patient advocacy are fundamental in the care delivered by HPRs for people with RMDs | QLIa | NA | 9.74 (0.65) 10 (8–10) |
C. An evidence-based approach, ethical conduct and reflective practice are essential for HPRs | QLIIb | NA | 9.68 (0.75) 10 (7–10) |
Recommendations | |||
1. HPRs should have knowledge of the aetiology, pathophysiology, epidemiology, clinical features and diagnostic procedures of common RMDs, including their impact on all aspects of life | QLIb | A | 9.42 (1.07) 10 (7–10) |
2. Using a structured assessment, HPRs should identify aspects that may influence individuals with RMDs and their families, including:
| QLIIa | B | 9.68 (0.58) 10 (8–10) |
3. HPRs should communicate effectively:
| QLIIa | B/C | 9.74 (0.73) 10 (7–10) |
4. HPRs should have an understanding of common pharmacological and surgical therapies in RMDs, including their anticipated benefits, side-effects and risks, and use this knowledge to advise or refer as appropriate | QLIb | B | 9.47 (0.84) 10 (8–10) |
5. HPRs should provide advice on non-pharmacological interventions, treat or refer as appropriate, based on the evidence, expected benefits, limitations and risks for people with RMDs | QLIb | B | 9.53 (0.90) 10 (7–10) |
6. HPRs should assess the educational needs of people with RMDs and their carers to provide tailored education using appropriate modes of delivery, relevant resources and evaluate their effectiveness | QLIb | A | 9.42 (1.02) 10 (6–10) |
7. HPRs should take responsibility for their continuous learning and ongoing professional development to remain up-to-date with the clinical guidelines and/or recommendations on the management of RMDs | QLIb | A | 9.79 (0.71) 10 (7–10) |
8. HPRs should support people with RMDs in goal setting and shared decision making about their care (eg, identify, prioritise, address their needs and preferences and explain in lay terms) | QLIIa | B | 9.42 (1.07) 10 (6–10) |
9. HPRs should support people with RMDs in self-management of their condition. This encompasses selecting and applying the appropriate behavioural approaches and techniques to optimise their health and well-being (eg, engagement in physical activity, pain and fatigue management) | QLIb | A | 9.74 (0.81) 10 (7–10) |
10. HPRs should be able to select and apply outcome measures for people with RMDs, as appropriate, to evaluate the effectiveness of their interventions | QLIb | A | 9.74 (0.73) 10 (7–10) |
ql Indicates a LoE based on studies that used primarily qualitative methods.
*Level of evidence from qualitative studies indicated for OAPs and recommendations for completeness.
LoE, level of evidence; NA, Not Applicable; OAPs, overarching principles; RMDs, rheumatic and musculoskeletal diseases.