Prof Ernest Choy – Cardiff University School of Medicine
Fatigue is a significant problem for people with rheumatoid arthritis, including physical exhaustion and cognitive impairment (when a person has trouble remembering, concentrating, or making decisions) with impacts on lifestyle, roles, relationships and emotions.
Fatigue is persistent and patients can feel unsupported with rheumatology nurses wanting help regarding fatigue management.
Cognitive behavioural therapy, a talking therapy that can help treat a wide range of emotional and physical health conditions, has proven to be a help, but few rheumatology units have clinical psychologists to deliver it.
The research team aimed to see if a group course delivered by rheumatology teams using cognitive-behavioural approaches, plus usual care, reduced RA fatigue impact more than usual care alone.
A two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT) was carried out. The trial took place across the UK at 7 centres. Trial patients were aged >18 years with confirmed fatigue severity which they considered recurrent or persistent.
Data was collected from over three hundred patients, over 26 weeks. The research showed that rheumatology nurses and occupational therapists using cognitive behavioural approaches reduced the short-term and long term effects of fatigue impact.
Looking at how this study’s findings might impact on clinical practice and future developments – with all seven clinical teams able to deliver this intervention, it suggests that future clinical implementation is feasible.