EULAR overarching principles and recommendations for the management of fatigue in people with I-RMDs.
| Overarching principles | ||
|---|---|---|
| 1. Health professionals should be aware that fatigue encompasses multiple and mutually interacting biological, psychological and social factors. | ||
| 2. In people with I-RMDs, fatigue should be monitored, and management options should be offered as part of their clinical care. | ||
| 3. Management of fatigue should be a shared decision between the person with an I-RMD and healthcare and well-being professionals. | ||
| 4. Management of fatigue should be based on the needs and preferences of people with I-RMDs, as well as their clinical disease activity, comorbidities and other individual psychosocial and/or contextual factors. | ||
| Recommendations | LoE | GoR |
| 1. Healthcare professionals should incorporate regular assessment of fatigue severity, impact and coping strategies into clinical consultations. | 5 | D |
| 2. As part of their clinical care, people with I-RMDs and fatigue should be offered access to tailored physical activity interventions and encouraged to engage in long-term physical activity. | 1a | A |
| 3. As part of their clinical care, people with I-RMDs and fatigue should be offered access to structured and tailored psychoeducational interventions. | 1a | A |
| 4. The presence or worsening of fatigue should trigger evaluation of inflammatory disease activity status and consideration of immunomodulatory treatment initiation or change, if clinically indicated. | 1a | A |
I-RMDs, inflammatory rheumatic and musculoskeletal diseases; GoR, Grade of recommendation; LoE, Level of Evidence. GoR and LoE as per 2011 Oxford Centre for Evidence Based Medicine Levels of Evidence.