Non-pharmacological interventions for fatigue in rheumatoid arthritis

Cramp, Fiona; Hewlett, Sarah; Almeida, Celia; Kirwan, John R; Choy, Ernest HS; Chalder, Trudie; Pollock, Jon; Christensen, Robin

doi:10.1002/14651858.cd008322.pub2

Cited by 221Rheumatoid Arthritis Research and TherapiesMusculoskeletal pain and rehabilitationCancer survivorship and care

Non-pharmacological interventions for fatigue in rheumatoid arthritis

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Cramp, Fiona, Hewlett, Sarah, Almeida, Celia, Kirwan, John R, Choy, Ernest HS, Chalder, Trudie, Pollock, Jon, Christensen, Robin·2013·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd008322.pub2PMC PMC11748118

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Abstract

BACKGROUND: Fatigue is a common and potentially distressing symptom for people with rheumatoid arthritis with no accepted evidence based management guidelines. Non-pharmacological interventions, such as physical activity and psychosocial interventions, have been shown to help people with a range of other long-term conditions to manage subjective fatigue. OBJECTIVES: To evaluate the benefit and harm of non-pharmacological interventions for the management of fatigue in people with rheumatoid arthritis. This included any intervention that was not classified as pharmacological in accordance with European Union (EU) Directive 2001/83/EEC. SEARCH METHODS: The following electronic databases were searched up to October 2012, Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; EMBASE; AMED; CINAHL; PsycINFO; Social Science Citation Index; Web of Science; Dissertation Abstracts International; Current Controlled Trials Register; The National Research Register Archive; The UKCRN Portfolio Database. In addition, reference lists of articles identified for inclusion were checked for additional studies and key authors were contacted. SELECTION CRITERIA: Randomised controlled trials were included if they evaluated a non-pharmacological intervention in people with rheumatoid arthritis with self-reported fatigue as an outcome measure. DATA COLLECTION AND ANALYSIS: Two review authors selected relevant trials, assessed risk of bias and extracted data. Where appropriate, data were pooled using meta-analysis with a random-effects model. MAIN RESULTS: Twenty-four studies met the inclusion criteria, with a total of 2882 participants with rheumatoid arthritis. Included studies investigated physical activity interventions (n = 6 studies; 388 participants), psychosocial interventions (n = 13 studies; 1579 participants), herbal medicine (n = 1 study; 58 participants), omega-3 fatty acid supplementation (n = 1 study; 81 participants), Mediterranean diet (n = 1 study; 51 participants), reflexology (n = 1 study; 11 participants) and the provision of Health Tracker information (n = 1 study; 714 participants). Physical activity was statistically significantly more effective than the control at the end of the intervention period (standardized mean difference (SMD) -0.36, 95% confidence interval (CI) -0.62 to -0.10; back translated to mean difference of 14.4 points lower, 95% CI -4.0 to -24.8 on a 100 point scale where a lower score means less fatigue; number needed to treat for an additional beneficial outcome (NNTB) 7, 95% CI 4 to 26) demonstrating a small beneficial effect upon fatigue. Psychosocial intervention was statistically significantly more effective than the control at the end of the intervention period (SMD -0.24, 95% CI -0.40 to -0.07; back translated to mean difference of 9.6 points lower, 95% CI -2.8 to -16.0 on a 100 point scale, lower score means less fatigue; NNTB 10, 95% CI 6 to 33) demonstrating a small beneficial effect upon fatigue. For the remaining interventions meta-analysis was not possible and there was either no statistically significant difference between trial arms or findings were not reported. Only three studies reported any adverse events and none of these were serious, however, it is possible that the low incidence was in part due to poor reporting. The quality of the evidence ranged from moderate quality for physical activity interventions and Mediterranean diet to low quality for psychosocial interventions and all other interventions. AUTHORS' CONCLUSIONS: This review provides some evidence that physical activity and psychosocial interventions provide benefit in relation to self-reported fatigue in adults with rheumatoid arthritis. There is currently insufficient evidence of the effectiveness of other non-pharmacological interventions.

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The overview authors state that the Cramp 2013 review's conclusion omitted any mention of study quality or risk of bias even though the results and discussion sections reported low or unclear quality scores.
“However, no mention of quality/risk of bias of studies in conclusion despite low/unclear quality score in results and discussion sections”
From Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (2017) · cites this paper as Cramp 2013
The overview authors note that the Cramp 2013 review drew no conclusions about the effect on pain because data were insufficient.
“No conclusions about effect on pain (insufficient data).”
From Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews (2017) · cites this paper as Cramp 2013

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Immunoadsorption for the Treatment of Rheumatoid Arthritis: Final Results of a Randomized Trial
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Wirksamkeitsnachweis eines Homöopathikums bei chronischer Polyarthritis - Eine randomisierte Doppelblindstudie bei niedergelassenen Ärzten
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Symptom Combinations Assessed in Traditional Chinese Medicine and Its Predictive Role in ACR20 Efficacy Response in Rheumatoid Arthritis
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Psychodynamic, Time-Limited Group Therapy in Rheumatic Disease – a Controlled Study with Special Reference to Alexithymia
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Balance training (proprioceptive training) for patients with rheumatoid arthritis.
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Patient perspective workshop: Fatigue as a recommended patient-centred outcome measure in rheumatoid arthritis
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Fatigue in Rheumatologic Diseases
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Study Quality Assessment
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Fatigue is related to poor pain outcomes in women with established rheumatoid arthritis.
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Fatigue in rheumatoid arthritis: Time for a conceptual model (Editorial)
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Assistive technology for rheumatoid arthritis
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Dynamic exercise therapy in patients with rheumatoid arthritis
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Literacy in Arthritis
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Iyengar yoga for young adults with rheumatoid arthritis
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Test of the health promotion model as a causal model of construction workers' use of hearing protection
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Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews
Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011279.pub3 · Cited by 1,222 · see citing works
Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews
Geneen, L. J., Moore, R. A., Clarke, C., Martin, D., Colvin, L. A., & Smith, B. H. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011279.pub2 · Cited by 719 · see citing works
EULAR recommendations for patient education for people with inflammatory arthritis
Zangi, H. A., Ndosi, M. E., Adams, J., Andersen, L., Bode, C., Boström, C., van Eijk‐Hustings, Y., Gossec, L., Korandová, J., Mendes, G., et al. (2015) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2014-206807 · Cited by 400 · see citing works
2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis
Nikiphorou, E., Santos, E. J. F., Marques, A., Böhm, P., Bijlsma, J. W. J., Daïen, C., Esbensen, B. A., Ferreira, R. J. O., Fragoulis, G. E., Holmes, P., et al. (2021) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2021-220249 · Cited by 318 · see citing works
2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases
Gwinnutt, J. M., Wieczorek, M., Balanescu, A. R., Bischoff-Ferrari, H. A., Boonen, A. E. R. C. H., Cavalli, G., de Souza, S., de Thurah, A. L., Dorner, T. E., Moe, R. H., et al. (2022) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2021-222020 · Cited by 269 · see citing works
Perceived Barriers, Facilitators and Benefits for Regular Physical Activity and Exercise in Patients with Rheumatoid Arthritis: A Review of the Literature
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The Burden of Disease in Rheumatoid Arthritis
Uhlig, T., Moe, R. H., & Kvien, T. K. (2014) · PharmacoEconomics · doi:10.1007/s40273-014-0174-6 · Cited by 209 · see citing works
The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies
Forsyth, C., Kouvari, M., D'Cunha, N. M., Georgousopoulou, E. N., Panagiotakos, D. B., Mellor, D. D., Kellett, J., & Naumovski, N. (2017) · Rheumatology International · doi:10.1007/s00296-017-3912-1 · Cited by 196 · see citing works
Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis
Osthoff, A.-K. R., Juhl, C. B., Knittle, K. P., Dagfinrud, H. S., Hurkmans, E. J., Braun, J., Schoones, J. W., Vlieland, T. P. M. V., & Niedermann, K. (2018) · RMD Open · doi:10.1136/rmdopen-2018-000713 · Cited by 168 · see citing works
The Effects of Aromatherapy Massage and Reflexology on Pain and Fatigue in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial
Metin, Z. G., & Özdemir, L. (2016) · Pain Management Nursing · doi:10.1016/j.pmn.2016.01.004 · Cited by 154 · see citing works
Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain
Polaski, A. M., Phelps, A. L., Kostek, M. C., Szucs, K. A., & Kolber, B. J. (2019) · PLoS ONE · doi:10.1371/journal.pone.0210418 · Cited by 150 · see citing works
A Systematic Review of Biological Mechanisms of Fatigue in Chronic Illness
Matura, L. A., Malone, S. K., Jaime-Lara, R. B., & Riegel, B. J. (2018) · Biological Research For Nursing · doi:10.1177/1099800418764326 · Cited by 143 · see citing works
EULAR recommendations for the non-pharmacological management of systemic lupus erythematosus and systemic sclerosis
Parodis, I., Girard-Guyonvarc’h, C., Arnaud, L., Distler, O., Domján, A., van den Ende, C. H. M., Fligelstone, K., Kocher, A., Larosa, M., Lau, M., et al. (2023) · Annals of the Rheumatic Diseases · doi:10.1136/ard-2023-224416 · Cited by 140 · see citing works
Fatigue in inflammatory rheumatic diseases: current knowledge and areas for future research
Davies, K., Dures, E. K., & Ng, W. (2021) · Nature Reviews Rheumatology · doi:10.1038/s41584-021-00692-1 · Cited by 143 · see citing works
Management of fatigue in rheumatoid arthritis
Pope, J. E. (2020) · RMD Open · doi:10.1136/rmdopen-2019-001084 · Cited by 137 · see citing works
Fatigue in Rheumatoid Arthritis
Katz, P. (2017) · Current Rheumatology Reports · doi:10.1007/s11926-017-0649-5 · Cited by 133 · see citing works
The Effect of Exercise on Sleep and Fatigue in Rheumatoid Arthritis: A Randomized Controlled Study
Durcan, L., Wilson, F., & Cunnane, G. (2014) · The Journal of Rheumatology · doi:10.3899/jrheum.131282 · Cited by 121 · see citing works
Anti-Inflammatory Diets and Fatigue
Haß, U., Herpich, C., & Norman, K. (2019) · Nutrients · doi:10.3390/nu11102315 · Cited by 120 · see citing works
Psychological correlates of fatigue in rheumatoid arthritis: A systematic review
Matcham, F., Ali, S., Hotopf, M. H., & Chalder, T. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.03.004 · Cited by 116 · see citing works
Self-citation
Role of Sleep Disturbance, Depression, Obesity, and Physical Inactivity in Fatigue in Rheumatoid Arthritis
Katz, P., Margaretten, M. E., Trupin, L. S., Schmajuk, G., Yazdany, J., & Yelin, E. H. (2015) · Arthritis Care & Research · doi:10.1002/acr.22577 · Cited by 117 · see citing works
The evidence base for psychological interventions for rheumatoid arthritis: a systematic review of reviews
Prothero, L., Barley, E., Galloway, J., Georgopoulou, S., & Sturt, J. (2018) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2018.03.008 · Cited by 115 · see citing works
Biologic interventions for fatigue in rheumatoid arthritis.
Almeida, C., Choy, E., Hewlett, S., Kirwan, J., Cramp, F., Chalder, T., Pollock, J., & Christensen, R. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008334.pub2 · Cited by 103 · see citing works
Self-citation
Effect of Aerobic Exercise Training on Fatigue in Rheumatoid Arthritis: A Meta‐Analysis
Dartel, S. A. A. R.-V., Repping‐Wuts, H., Flendrie, M., Bleijenberg, G., Metsios, G. S., van den Hout, W. B., van den Ende, C. H. M., Neuberger, G. B., Reid, A., van Riel, P. L. C. M., et al. (2015) · Arthritis Care & Research · doi:10.1002/acr.22561 · Cited by 106 · see citing works
Suppressing Inflammation in Rheumatoid Arthritis: Does Patient Global Assessment Blur the Target? A Practice‐Based Call for a Paradigm Change
Ferreira, R. J. O., Duarte, C. C. M., Ndosi, M. E., de Wit, M. P. T., Gossec, L., & da Silva, J. A. P. (2017) · Arthritis Care & Research · doi:10.1002/acr.23284 · Cited by 104 · see citing works
Yoga in Sedentary Adults with Arthritis: Effects of a Randomized Controlled Pragmatic Trial
Moonaz, S. H., Bingham, C. O., Wissow, L., & Bartlett, S. J. (2015) · The Journal of Rheumatology · doi:10.3899/jrheum.141129 · Cited by 98 · see citing works
Effectiveness of Occupational Therapy Interventions for Adults With Rheumatoid Arthritis: A Systematic Review
Siegel, P., Tencza, M., Apodaca, B., & Poole, J. L. (2016) · American Journal of Occupational Therapy · doi:10.5014/ajot.2017.023176 · Cited by 98 · see citing works
Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions
Reid, H., Ridout, A. J., Tomaz, S. A., Kelly, P., & Jones, N. (2022) · British Journal of Sports Medicine · doi:10.1136/bjsports-2021-104281 · Cited by 97 · see citing works
Interventions for fatigue in inflammatory bowel disease
Farrell, D., Artom, M., Czuber-Dochan, W., Jelsness-Jørgensen, L. P., Norton, C., & Savage, E. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012005.pub2 · Cited by 89 · see citing works
Nonpharmacological treatment in established rheumatoid arthritis
Küçükdeveci, A. A. (2019) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2019.101482 · Cited by 85 · see citing works
Fatigue in rheumatoid arthritis; a persistent problem: a large longitudinal study
van Steenbergen, H. W., Tsonaka, R., Huizinga, T. W. J., Boonen, A. E. R. C. H., & Mil, A. H. M. V. D. H. (2015) · RMD Open · doi:10.1136/rmdopen-2014-000041 · Cited by 85 · see citing works
Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial
Feldthusen, C., Dean, E., Forsblad‐d’Elia, H., & Mannerkorpi, K. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.09.022 · Cited by 82 · see citing works
The Experience of people with rheumatoid arthritis living with fatigue: a qualitative metasynthesis
Primdahl, J., Hegelund, A., Lorenzen, A. G., Loeppenthin, K., Dures, E. K., & Esbensen, B. A. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-024338 · Cited by 80 · see citing works
The Role of Physical Exercise in Chronic Musculoskeletal Pain: Best Medicine—A Narrative Review
la Corte‐Rodríguez, H. D., Román-Belmonte, J. M., Luis, C. R., Madrid-Gonzalez, J., & Rodriguez-Merchan, E. C. (2024) · Healthcare · doi:10.3390/healthcare12020242 · Cited by 86 · see citing works
Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials
Nelson, J., Sjöblom, H., Gjertsson, I., Ulven, S. M., Lindqvist, H. M., & Bärebring, L. (2020) · Nutrients · doi:10.3390/nu12102991 · Cited by 81 · see citing works
Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs
Gwinnutt, J. M., Wieczorek, M., Rodríguez‐Carrio, J., Balanescu, A. R., Bischoff-Ferrari, H. A., Boonen, A. E. R. C. H., Cavalli, G., de Souza, S., de Thurah, A. L., Dorner, T. E., et al. (2022) · RMD Open · doi:10.1136/rmdopen-2021-002167 · Cited by 77 · see citing works
Fatigue interventions in long term, physical health conditions: A scoping review of systematic reviews
Hulme, K., Safari, R., Thomas, S., Mercer, T. H., White, C. M., van der Linden, M. L., & Moss-Morris, R. E. (2018) · PLoS ONE · doi:10.1371/journal.pone.0203367 · Cited by 76 · see citing works
Reducing arthritis fatigue impact: two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT)
HEWLETT, S. E., Almeida, C., Ambler, N., Blair, P. S., Choy, E., Dures, E. K., Hammond, A., Hollingworth, W., Kadir, B., Kirwan, J., et al. (2019) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2018-214469 · Cited by 75 · see citing works
Self-citation
A biopsychosocial network model of fatigue in rheumatoid arthritis: a systematic review
Geenen, R., & Dures, E. K. (2019) · Lara D. Veeken · doi:10.1093/rheumatology/kez403 · Cited by 73 · see citing works
Predictors of fatigue in rheumatoid arthritis
Druce, K. L., & Basu, N. (2019) · Lara D. Veeken · doi:10.1093/rheumatology/kez346 · Cited by 72 · see citing works
Predictors of Fatigue in Rheumatoid Arthritis Patients in Remission or in a Low Disease Activity State
Olsen, C. L., Lie, E., Kvien, T. K., & Zangi, H. A. (2015) · Arthritis Care & Research · doi:10.1002/acr.22787 · Cited by 69 · see citing works
Celecoxib for rheumatoid arthritis
Fidahić, M., Kadić, A. J., Radić, M., & Puljak, L. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012095.pub2 · Cited by 68 · see citing works
Psychosocial management of chronic pain in patients with rheumatoid arthritis: Challenges and solutions
Sharpe, L. (2016) · Journal of Pain Research · doi:10.2147/jpr.s83653 · Cited by 64 · see citing works
“These results are interesting because, although there has been an increase in recent years in research targeting fatigue as a primary outcome, a Cochrane review 28 found that the evidence for psychosocial interventions effectively targeting fatigue remains low.”
Targets for Health Interventions for Inflammatory Bowel Disease-fatigue
Artom, M., Czuber‐Dochan, W., Sturt, J. A., & Norton, C. S. (2016) · Journal of Crohn s and Colitis · doi:10.1093/ecco-jcc/jjw029 · Cited by 64 · see citing works
Improvement of Fatigue and Quality of Life in Patients with Quiescent Inflammatory Bowel Disease Following a Personalized Exercise Program
van Erp, L. W., Roosenboom, B., Komdeur, P., Dijkstra-Heida, W., Wisse, J., Horje, C. S. H. T., Liem, C. S., van Cingel, R. E. H., Wahab, P. J., & Groenen, M. J. M. (2020) · Digestive Diseases and Sciences · doi:10.1007/s10620-020-06222-5 · Cited by 62 · see citing works
Determining Pathways to Improvements in Fatigue in Rheumatoid Arthritis: Results From the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis
Druce, K. L., Jones, G. T., Macfarlane, G. J., & Basu, N. (2015) · Arthritis & Rheumatology · doi:10.1002/art.39238 · Cited by 61 · see citing works
Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis
Marques, A., Santos, E. J. F., Nikiphorou, E., Bosworth, A., & Carmona, L. (2021) · RMD Open · doi:10.1136/rmdopen-2021-001647 · Cited by 57 · see citing works
Effectiveness of Aquatic Exercises in Women With Rheumatoid Arthritis
Siqueira, U. S., Valente, L. G. O., de Mello, M. T., Szejnfeld, V. L., & Pinheiro, M. M. (2016) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000000564 · Cited by 57 · see citing works
Ideal food pyramid for patients with rheumatoid arthritis: A narrative review
Rondanelli, M., Perdoni, F., Peroni, G., Caporali, R. F., Gasparri, C., Riva, A., Petrangolini, G., Faliva, M. A., Infantino, V., Naso, M., et al. (2020) · Clinical Nutrition · doi:10.1016/j.clnu.2020.08.020 · Cited by 57 · see citing works
Consensus statement on a framework for the management of comorbidity and extra-articular manifestations in rheumatoid arthritis
Loza, E., Lajas, C., Andreu, J. L., Balsa, A., González‐Álvaro, I., Illera, Ó., Jover, J. Á., Mateo, I., Orte, J., Rivera, J., et al. (2014) · Rheumatology International · doi:10.1007/s00296-014-3196-7 · Cited by 52 · see citing works
A mixed-methods systematic review of post-viral fatigue interventions: Are there lessons for long Covid?
Fowler‐Davis, S., Platts, K., Thelwell, M., Woodward, A., & Harrop, D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0259533 · Cited by 51 · see citing works
The Longitudinal Course of Fatigue in Rheumatoid Arthritis: Results from the Norfolk Arthritis Register
Druce, K. L., Jones, G. T., Macfarlane, G. J., Verstappen, S. M. M., & Basu, N. (2015) · The Journal of Rheumatology · doi:10.3899/jrheum.141498 · Cited by 50 · see citing works
Current trends in theranostics for rheumatoid arthritis
Madav, Y., Barve, K. H., & Prabhakar, B. R. (2020) · European Journal of Pharmaceutical Sciences · doi:10.1016/j.ejps.2020.105240 · Cited by 50 · see citing works
Effectiveness of non-pharmacological and non-surgical interventions for rheumatoid arthritis: an umbrella review
Santos, E. J. F., Duarte, C. C. M., Marques, A., Cardoso, D., Apóstolo, J., da Silva, J. A. P., & Barbieri‐Figueiredo, M. D. C. (2019) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-d-18-00020 · Cited by 48 · see citing works
2018 Chinese Guidelines for the Diagnosis and Treatment of Rheumatoid Arthritis
Tian, X.-P., Wang, Q., Li, M.-T., Zhao, Y., Zhang, Z.-Y., Huang, C.-B., Liu, Y., Xu, H.-J., Chen, Y.-L., Wu, L.-J., et al. (2021) · Rheumatology and Immunology Research · doi:10.2478/rir-2021-0002 · Cited by 40 · see citing works
Non-pharmacological treatment in difficult-to-treat rheumatoid arthritis
Majnik, J., Császár-Nagy, N., Böcskei, G., Bender, T., & Nagy, G. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.991677 · Cited by 47 · see citing works
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Non-pharmacological interventions for fatigue in rheumatoid \narthritis (Review)
Cramp, F. A., Hewlett, S., Almeida, C., Kirwan, J. R., Choy, E., Chalder, T., Pollock, J. I., & Christensen, R. (2013) · UWE Research Repository (UWE Bristol)
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Non-pharmacological interventions for fatigue in rheumatoidarthritis (Protocol)
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The role of non-pharmacological interventions in the management of rheumatoid-arthritis-related fatigue
Cramp, F. L. (2019) · Lara D. Veeken · doi:10.1093/rheumatology/kez310 · Cited by 41 · see citing works
Self-citation
Efficacy of non-pharmacological interventions: a systematic review informing the 2023 EULAR recommendations for the management of fatigue in people with inflammatory rheumatic and musculoskeletal diseases
Santos, E. J. F., Farisoğulları, B., Dures, E. K., Geenen, R., & Machado, P. (2023) · RMD Open · doi:10.1136/rmdopen-2023-003350 · Cited by 45 · see citing works
OP0182-HPR EFFICACY OF NON-PHARMACOLOGICAL INTERVENTIONS: A SYSTEMATIC REVIEW INFORMING THE 2023 EULAR RECOMMENDATIONS FOR THE MANAGEMENT OF FATIGUE IN PEOPLE WITH INFLAMMATORY RHEUMATIC AND MUSCULOSKELETAL DISEASES
Santos, E. J. F., Farisoğulları, B., Dures, E. K., & Machado, P. (2023) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2023-eular.1627

Authors: Cramp, F., Hewlett, S., Almeida, C., Kirwan, J. R., Choy, E. H., Chalder, T., Pollock, J., & Christensen, R.
Affiliations: University of the West of England (GB)
Bristol Royal Infirmary (GB)
Cardiff University (GB)
King's College London (GB)
Copenhagen University Hospital (DK)
ORCID: Cramp, Fiona
Hewlett, Sarah
Almeida, Celia
Kirwan, John R
Choy, Ernest HS
Chalder, Trudie
Pollock, Jon
Christensen, Robin
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2013-08-23
Volume: 2013
Issue: 8
Pages: CD008322-CD008322
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd008322.pub2
PMC: PMC11748118
OpenAlex: W1916406953
Cited by: 221
References: 106
Citations by year: 2026: 4 · 2025: 10 · 2024: 19 · 2023: 18 · 2022: 17 · 2021: 22 · 2020: 19 · 2019: 26 · 2018: 24 · 2017: 18 · 2016: 12 · 2015: 24 · 2014: 7
FWCI: 2.33
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Bristol Research (University of Bristol) (submittedVersion)
Explore Bristol Research (submittedVersion)
UWE Research Repository (UWE Bristol) (submittedVersion, cc-by)
Topics: Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords: rheumatoid arthritis, non-pharmacological treatment, physical activity, psychosocial interventions, cognitive behavioral therapy, relaxation training, herbal medicine, omega-3 fatty acids, Mediterranean diet, reflexology, fatigue management, symptom burden, quality of life, anxiety, sleep disorders, risk of bias, harm, cost-effectiveness
MeSH terms: Adult, Arthritis, Rheumatoid, Exercise Therapy, Fatigue, Humans, Middle Aged, Psychotherapy, Reflexotherapy, Fatty Acids, Omega-3, Diet, Mediterranean, Pain Management

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