TY - JOUR
T1 - 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases
AU - Dures, Emma
AU - Farisoğulları, Bayram
AU - Santos, Eduardo José Ferreira
AU - Molto, Anna
AU - Feldthusen, Caroline
AU - Harris, Claire
AU - Elling-Audersch, Corinna
AU - Connolly, Deirdre
AU - Elefante, Elena
AU - Estévez-López, Fernando
AU - Bini, Ilaria
AU - Primdahl, Jette
AU - Hoeper, Kirsten
AU - Urban, Marie
AU - van de Laar, Mart A F J
AU - Redondo, Marta
AU - Böhm, Peter
AU - Amarnani, Raj
AU - Hayward, Rhys
AU - Geenen, Rinie
AU - Rednic, Simona
AU - Pettersson, Susanne
AU - Thomsen, Tanja
AU - Uhlig, Till
AU - Ritschl, Valentin
AU - Machado, Pedro M
N1 - © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/9/30
Y1 - 2024/9/30
N2 - 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.
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.
KW - Europe
KW - Fatigue/therapy
KW - Humans
KW - Musculoskeletal Diseases/complications
KW - Rheumatic Diseases/complications
UR - http://www.scopus.com/inward/record.url?scp=85181919764&partnerID=8YFLogxK
U2 - 10.1136/ard-2023-224514
DO - 10.1136/ard-2023-224514
M3 - Journal article
C2 - 38050029
SN - 0003-4967
VL - 83
SP - 1260
EP - 1267
JO - Annals of the Rheumatic Diseases
JF - Annals of the Rheumatic Diseases
IS - 10
ER -