2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis
EULAR · 2021 · Europe
Source and licence
- Authors
- Elena Nikiphorou, Eduardo José Ferreira Santos, Andrea Marques et al.
- Title
- 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis
- Journal
- Annals of the Rheumatic Diseases, 2021
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC8458093
Licence statement of the original publication
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Recommendations
Verbatim, with grade of recommendation or strength of consensus where given.
Recommendations
- R1HCPs should encourage patients to become active partners of the team and make them aware of HCPs and patient organisations involved in all aspects of the care pathway.LoE(1–5): 5; SoR (A–D): D; Level of agreement(0–10) Mean (SD): 9.5 (1.1); Level of agreement(0–10) % with score ≥8: 87
- R2Patient education should be the start point and underpin all self-management interventions.LoE(1–5): 1A; SoR (A–D): A; Level of agreement(0–10) Mean (SD): 9.5 (0.8); Level of agreement(0–10) % with score ≥8: 93
- R3Self-management interventions that include problem solving and goal setting and, where relevant to the individual and available, cognitive behavioural therapy should be incorporated into routine clinical practice to support patients.LoE(1–5): 1A; SoR (A–D): A; Level of agreement(0–10) Mean (SD): 9.1 (1.4); Level of agreement(0–10) % with score ≥8: 93
- R4HCPs should actively promote physical activity at diagnosis and throughout the disease course.LoE(1–5): 1A; SoR (A–D): A; Level of agreement(0–10) Mean (SD): 9.9 (0.3); Level of agreement(0–10) % with score ≥8: 100
- R5Lifestyle advice based on evidence should be given to better manage common comorbidity and patients should be guided and encouraged by their healthcare team to adopt healthy behaviours.LoE(1–5): 5; SoR (A–D): D; Level of agreement(0–10) Mean (SD): 9.6 (0.6); Level of agreement(0–10) % with score ≥8: 100
- R6Better emotional well-being leads to better self-management; therefore, mental health needs to be assessed periodically and appropriate intervention should be made if necessary.LoE(1–5): 5; SoR (A–D): D; Level of agreement(0–10) Mean (SD): 9.4 (1.3); Level of agreement(0–10) % with score ≥8: 93
- R7HCPs should invite discussion with patients about work and signpost to sources of help where appropriate or where needed.LoE(1–5): 5; SoR (A–D): D; Level of agreement(0–10) Mean (SD): 9.6 (0.5); Level of agreement(0–10) % with score ≥8: 100
- R8Digital healthcare can help patients to self-manage and should be considered for inclusion in supported self-management where appropriate and available.LoE(1–5): 1B; SoR (A–D): A; Level of agreement(0–10) Mean (SD): 9.3 (1.0); Level of agreement(0–10) % with score ≥8: 93
- R9HCPs should make themselves aware of available resources to signpost patients to, as part of optimising and supporting self-management.LoE(1–5): 5; SoR (A–D): D; Level of agreement(0–10) Mean (SD): 8.7 (1.2); Level of agreement(0–10) % with score ≥8: 100
Abstract
Background: An important but often insufficient aspect of care in people with inflammatory arthritis (IA) is empowering patients to acquire a good understanding of their disease and building their ability to deal effectively with the practical, physical and psychological impacts of it. Self-management skills can be helpful in this regard.
Objectives: To develop recommendations for the implementation of self-management strategies in IA.
Methods: A multidisciplinary taskforce of 18 members from 11 European countries was convened. A systematic review and other supportive information (survey of healthcare professionals (HCPs) and patient organisations) were used to formulate the recommendations.
Results: Three overarching principles and nine recommendations were formulated. These focused on empowering patients to become active partners of the team and to take a more proactive role. The importance of patient education and key self-management interventions such as problem solving, goal setting and cognitive behavioural therapy were highlighted. Role of patient organisations and HCPs in promoting and signposting patients to available resources has been highlighted through the promotion of physical activity, lifestyle advice, support with mental health aspects and ability to remain at work. Digital healthcare is essential in supporting and optimising self-management and the HCPs need to be aware of available resources to signpost patients.
Conclusion: These recommendations support the inclusion of self-management advice and resources in the routine management of people with IA and aim to empower and support patients and encourage a more holistic, patient-centred approach to care which could result in improved patient experience of care and outcomes.
Contents of the original publication
The section headings of the original.
- Introduction
- Methods
- Results
- Definition
- Overarching principles
- Recommendations
- Discussion
- Conclusions
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