Routine inflammatory arthritis care should include self-management strategies
Source / Disclosures
Nikiphorou reports personal and other expenses of AbbVie, Eli-Lilly & Co., Gilead Sciences, Celltrion and Pfizer and others from Sanofi. Please see the study for relevant financial information from all other authors.
Routine care for inflammatory arthritis should include self-management strategies that include problem solving, goal setting and, if possible, cognitive behavioral therapy, according to the new EULAR recommendations.
EULAR has published the recommendations, which cover the implementation of self-management interventions in patients with inflammatory arthritis, in the Annals of Rheumatic Diseases.
“These recommendations cover a significant unmet need in the care of people living with inflammatory arthritis (AI) and highlight the beneficial effects of self-management and its components. Elena Nikiphorou, MBBS /B.Sc. (Hons), MRCP, MBBS, PGCME, MD (Res), FHEA, from King’s College London, said Healio Rheumatology. “They provide guidance on integrating self-management interventions into the routine clinical care of people with IA, advocating for a greater focus on goals that are more meaningful to patients, in the context of their daily lives.”
“Therefore, these recommendations have the potential to improve the management of people with IA, encourage a more holistic approach to their care, and empower and support patients throughout their journey,” he said. she adds.
To develop recommendations for the implementation of self-management interventions in inflammatory arthritis, EULAR formed a multidisciplinary working group of 18 members from 11 European countries. Members’ backgrounds and specialties included rheumatology, nursing, occupational therapy, psychology, self-management, exercise physiology and physiotherapy. The group also included representatives from patients who offered first-hand experiences with inflammatory arthritis.
Members of the working group conducted a systematic literature review and met twice – once in person and once virtually – to discuss the evidence, definitions and general principles. The recommendations themselves were drafted during the second meeting, with input from best practice examples from patient organizations, and then approved by two ballots.
In all, the working group approved three general principles and nine recommendations. According to general principles, self-management “involves playing an active role in learning about one’s condition” and in the process of shared decision-making. In addition, the working group found that self-efficacy has a “positive effect on various aspects of life with IA”. Finally, the group said that patient organizations “often provide valuable resources for self-management and collaboration” among healthcare professionals.
The nine recommendations are:
- Providers should encourage patients to be active partners in the healthcare team and educate them about professionals and patient organizations involved in all aspects of their care;
- Patient education should be the starting point and foundation for all self-management strategies;
- Self-management strategies that include problem solving and goal setting and, where relevant and possible, cognitive behavioral therapy, should be included in routine clinical practice;
- Providers should promote physical activity from diagnosis throughout the course of the disease;
- Patients should receive evidence-based lifestyle counseling to better manage common co-morbidities;
- Patients’ mental health should be assessed “periodically”, with appropriate interventions available if necessary;
- Healthcare professionals should initiate discussions about patient work and “point out” useful resources, where appropriate;
- Digital healthcare options should be considered to be included in assisted self-management, where appropriate and available and
- Providers should learn about available resources that can help their patients.
“For self-management to be effective, it is imperative that healthcare professionals receive adequate professional counseling and training,” Nikiphorou said. “This can improve their commitment to supporting clinical self-management and patient referral, as well as their overall confidence to support self-management. ”
“These recommendations provide guidance to healthcare professionals on how to integrate self-management recommendations into routine clinical care,” she added. “Adherence to these recommendations has the potential to improve patient care and outcomes in people living with IA and encourage a more active patient role in disease management. “