2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases

Emma Dures*, Bayram Farisoğulları, Eduardo José Ferreira Santos, Anna Molto, Caroline Feldthusen, Claire Harris, Corinna Elling-Audersch, Deirdre Connolly, Elena Elefante, Fernando Estévez-López, Ilaria Bini, Jette Primdahl, Kirsten Hoeper, Marie Urban, Mart A F J van de Laar, Marta Redondo, Peter Böhm, Raj Amarnani, Rhys Hayward, Rinie GeenenSimona Rednic, Susanne Pettersson, Tanja Thomsen, Till Uhlig, Valentin Ritschl, Pedro M Machado

*Corresponding author for this work
15 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalAnnals of the Rheumatic Diseases
Volume83
Issue number10
Pages (from-to)1260-1267
Number of pages8
ISSN0003-4967
DOIs
Publication statusPublished - 30 Sept 2024

Keywords

  • Europe
  • Fatigue/therapy
  • Humans
  • Musculoskeletal Diseases/complications
  • Rheumatic Diseases/complications

Fingerprint

Dive into the research topics of '2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases'. Together they form a unique fingerprint.

Cite this