Self-management of fatigue in rheumatoid arthritis: a randomised controlled trial of group cognitive-behavioural therapy

Objectives To investigate the effect of group cognitive behavioural therapy (CBT) for fatigue self-management, compared with groups receiving fatigue information alone, on fatigue impact among people with rheumatoid arthritis (RA). Methods Two-arm, parallel randomised controlled trial in adults with...

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Vydané v:Annals of the rheumatic diseases Ročník 70; číslo 6; s. 1060 - 1067
Hlavní autori: Hewlett, Sarah, Ambler, Nick, Almeida, Celia, Cliss, Alena, Hammond, Alison, Kitchen, Karen, Knops, Bev, Pope, Denise, Spears, Melissa, Swinkels, Annette, Pollock, Jon
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.06.2011
BMJ Publishing Group
Elsevier Limited
BMJ Group
Edícia:Extended report
Predmet:
Adaptation, Psychological
Adult
Aged
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - psychology
Behavior
Biological and medical sciences
Chronic fatigue syndrome
Clinical and Epidemiological Research
Cognitive Behavioral Therapy - methods
Disease
Diseases of the osteoarticular system
Fatigue - etiology
Fatigue - psychology
Fatigue - therapy
Female
Follow-Up Studies
Humans
Inflammation
Inflammatory joint diseases
Intervention
Male
Medical sciences
Middle Aged
Pain
Psychotherapy, Group - methods
Quality of life
Rheumatology
Self Care - methods
Severity of Illness Index
Treatment Outcome
Immunopathology
Chronic
Cognitive therapy
Treatment
Rheumatoid arthritis
Diseases of the osteoarticular system
Rheumatology
Autoimmune disease
Fatigue
Inflammatory joint disease
ISSN:0003-4967, 1468-2060, 1468-2060
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Shrnutí:Objectives To investigate the effect of group cognitive behavioural therapy (CBT) for fatigue self-management, compared with groups receiving fatigue information alone, on fatigue impact among people with rheumatoid arthritis (RA). Methods Two-arm, parallel randomised controlled trial in adults with RA, fatigue ≥6/10 (Visual Analogue Scale (VAS) 0–10, high bad) and no recent change in RA medication. Group CBT for fatigue self-management comprised six (weekly) 2 h sessions, and consolidation session (week 14). Control participants received fatigue self-management information in a 1 h didactic group session. Primary outcome at 18 weeks was the impact of fatigue measured using two methods (Multi-dimensional Assessment of Fatigue (MAF) 0–50; VAS 0–10), analysed using intention-to-treat analysis of covariance with multivariable regression models. Results Of 168 participants randomised, 41 withdrew before entry and 127 participated. There were no major baseline differences between the 65 CBT and 62 control participants. At 18 weeks CBT participants reported better scores than control participants for fatigue impact: MAF 28.99 versus 23.99 (adjusted difference −5.48, 95% CI −9.50 to −1.46, p=0.008); VAS 5.99 versus 4.26 (adjusted difference −1.95, 95% CI −2.99 to −0.90, p<0.001). Standardised effect sizes for fatigue impact were MAF 0.59 (95% CI 0.15 to 1.03) and VAS 0.77 (95% CI 0.33 to 1.21), both in favour of CBT. Secondary outcomes of perceived fatigue severity, coping, disability, depression, helplessness, self-efficacy and sleep were also better in CBT participants. Conclusions Group CBT for fatigue self-management in RA improves fatigue impact, coping and perceived severity, and well-being. Trial registration: ISRCTN 32195100
Bibliografia:istex:BD8AF681855ADA794EB1D1FC52808A832FDEC063
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ArticleID:annrheumdis144691
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ISSN:0003-4967
1468-2060
1468-2060
DOI:10.1136/ard.2010.144691