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Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study

OBJECTIVES: Patients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes...

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Autores principales: Dures, Emma, Bridgewater, Susan, Abbott, Bryan, Adams, Jo, Berry, Alice, McCracken, Lance M, Creanor, Siobhan, Hewlett, Sarah, Lomax, Joe, Ndosi, Mwidimi, Thorn, Joanna, Urban, Marie, Ewings, Paul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297231/
https://www.ncbi.nlm.nih.gov/pubmed/35851019
http://dx.doi.org/10.1136/bmjopen-2021-054627
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author Dures, Emma
Bridgewater, Susan
Abbott, Bryan
Adams, Jo
Berry, Alice
McCracken, Lance M
Creanor, Siobhan
Hewlett, Sarah
Lomax, Joe
Ndosi, Mwidimi
Thorn, Joanna
Urban, Marie
Ewings, Paul
author_facet Dures, Emma
Bridgewater, Susan
Abbott, Bryan
Adams, Jo
Berry, Alice
McCracken, Lance M
Creanor, Siobhan
Hewlett, Sarah
Lomax, Joe
Ndosi, Mwidimi
Thorn, Joanna
Urban, Marie
Ewings, Paul
author_sort Dures, Emma
collection PubMed
description OBJECTIVES: Patients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis (FREE-IA) study tested the feasibility of RHP training, intervention delivery and outcome collection ahead of a potential trial of clinical and cost-effectiveness. METHODS: In this single-arm feasibility study, eligible patients were ≥18 years, had a clinician-confirmed diagnosis of an inflammatory arthritis and scored ≥6/10 on the Bristol Rheumatoid Arthritis Fatigue (BRAF) Numerical Rating Scale (NRS) Fatigue Effect. Following training, RHPs delivered two to four sessions to participants. Baseline data were collected before the first session (T0) and outcomes at 6 weeks (T1) and 6 months (T2). The proposed primary outcome was fatigue impact (BRAF NRS Fatigue Effect). Secondary outcomes included fatigue severity and coping, disease impact and disability, and measures of therapeutic mechanism (self-efficacy and confidence to manage health). RESULTS: Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 (9.4%) and 27 (19.6%) missing primary and secondary outcome responses, respectively. Results indicated improvements in all measures except disability, at either T1 or T2, or both. CONCLUSIONS: This study showed it was feasible to deliver the intervention, including training RHPs, and recruit and follow-up participants with high retention. While there was no control group, observed within-group improvements suggest potential promise of the intervention and support for a definitive trial to test effectiveness.
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spelling pubmed-92972312022-08-09 Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study Dures, Emma Bridgewater, Susan Abbott, Bryan Adams, Jo Berry, Alice McCracken, Lance M Creanor, Siobhan Hewlett, Sarah Lomax, Joe Ndosi, Mwidimi Thorn, Joanna Urban, Marie Ewings, Paul BMJ Open Rheumatology OBJECTIVES: Patients with inflammatory arthritis report that fatigue is challenging to manage. We developed a manualised, one-to-one, cognitive–behavioural intervention, delivered by rheumatology health professionals (RHPs). The Fatigue - Reducing its Effects through individualised support Episodes in Inflammatory Arthritis (FREE-IA) study tested the feasibility of RHP training, intervention delivery and outcome collection ahead of a potential trial of clinical and cost-effectiveness. METHODS: In this single-arm feasibility study, eligible patients were ≥18 years, had a clinician-confirmed diagnosis of an inflammatory arthritis and scored ≥6/10 on the Bristol Rheumatoid Arthritis Fatigue (BRAF) Numerical Rating Scale (NRS) Fatigue Effect. Following training, RHPs delivered two to four sessions to participants. Baseline data were collected before the first session (T0) and outcomes at 6 weeks (T1) and 6 months (T2). The proposed primary outcome was fatigue impact (BRAF NRS Fatigue Effect). Secondary outcomes included fatigue severity and coping, disease impact and disability, and measures of therapeutic mechanism (self-efficacy and confidence to manage health). RESULTS: Eight RHPs at five hospitals delivered 113 sessions to 46 participants. Of a potential 138 primary and secondary outcome responses at T0, T1 and T2, there were 13 (9.4%) and 27 (19.6%) missing primary and secondary outcome responses, respectively. Results indicated improvements in all measures except disability, at either T1 or T2, or both. CONCLUSIONS: This study showed it was feasible to deliver the intervention, including training RHPs, and recruit and follow-up participants with high retention. While there was no control group, observed within-group improvements suggest potential promise of the intervention and support for a definitive trial to test effectiveness. BMJ Publishing Group 2022-07-18 /pmc/articles/PMC9297231/ /pubmed/35851019 http://dx.doi.org/10.1136/bmjopen-2021-054627 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Rheumatology
Dures, Emma
Bridgewater, Susan
Abbott, Bryan
Adams, Jo
Berry, Alice
McCracken, Lance M
Creanor, Siobhan
Hewlett, Sarah
Lomax, Joe
Ndosi, Mwidimi
Thorn, Joanna
Urban, Marie
Ewings, Paul
Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
title Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
title_full Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
title_fullStr Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
title_full_unstemmed Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
title_short Brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
title_sort brief intervention to reduce fatigue impact in patients with inflammatory arthritis: design and outcomes of a single-arm feasibility study
topic Rheumatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297231/
https://www.ncbi.nlm.nih.gov/pubmed/35851019
http://dx.doi.org/10.1136/bmjopen-2021-054627
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