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Review
. 2021 Dec;7(3):e001959.
doi: 10.1136/rmdopen-2021-001959.

Call for action: incorporating wellness practices into a holistic management plan for rheumatoid arthritis-going beyond treat to target

Peter C Taylor  1 , Mart Van de Laar  2 , Andrew Laster  3 , Walid Fakhouri  4 , Amanda Quebe  4 , Inmaculada de la Torre  4 , Saundra Jain  5
Affiliations
Review

Call for action: incorporating wellness practices into a holistic management plan for rheumatoid arthritis-going beyond treat to target

Peter C Taylor et al. RMD Open. 2021 Dec.

Abstract

This expert opinion article explores the strategy of adopting a holistic approach to the management of rheumatoid arthritis (RA) by incorporating the wellness practices of exercise, optimised sleep, optimised nutrition, mindfulness, social connectedness and positive emotions into the management plan. The aim is to attain optimal health for each patient beyond that achievable by limiting disease management to pharmacological treatment to attain the lowest achievable composite scores of disease activity, as recommended with the current treat-to-target approach, and addressing the recent recognition of pain control as a key patient-reported outcome. Incorporating wellness practices into a busy clinical setting requires creativity and customisation based on the individual practice setting and the individual needs of each patient. Such practices can help people living with RA to achieve optimum wellness through the introduction of measures-according to individual need-designed to improve the aspects of life most impacted for that person, thereby complementing treat-to-target and pain control strategies with pharmacological agents. Clinicians must consider wellness practices in addition to treat-to-target pharmacological agents for the holistic management of people with RA.

Keywords: autoimmune diseases; patient care team; physical therapy modalities; rheumatoid arthritis.

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Conflict of interest statement

Competing interests: PT: Research grants from Celgene and Galapagos and consultation fees from AbbVie, Biogen, Galapagos, Gilead, GlaxoSmithKline, Janssen, Lilly, Pfizer, BMS, Roche, Sanofi, Nordic Pharma, Fresenius and UCB. SJ has served as a consultant, member of advisory boards and/or speaker bureaus for Eli Lilly, Otsuka, Pamlab and Sunovion. MVdL reports educational grants and speaker’s–advisory fees from Eli Lilly and Company not related to this work. AL has been member of speaker bureaus for Lilly, Novartis, Amgen, Exage, Myria and Pfizer and a consultant for Amgen. WF, AQ and IdlT are employees of Eli Lilly and Company.

References

    1. National Wellness Institute . The six dimensions of wellness. Available: https://nationalwellness.org/resources/six-dimensions-of-wellness/ [Accessed 12 Oct 2020].
    1. Stuifbergen AK, Morris M, Jung JH, et al. . Benefits of wellness interventions for persons with chronic and disabling conditions: a review of the evidence. Disabil Health J 2010;3:133–45. 10.1016/j.dhjo.2009.10.007 - DOI - PMC - PubMed
    1. Fraenkel L, Bathon JM, England BR, et al. . American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol 2021;2021:1108–23. - PubMed
    1. Smolen JS, Landewé RBM, Bijlsma JWJ, et al. . EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020;79:685–99. 10.1136/annrheumdis-2019-216655 - DOI - PubMed
    1. Fautrel B, Alten R, Kirkham B, et al. . Call for action: how to improve use of patient-reported outcomes to guide clinical decision making in rheumatoid arthritis. Rheumatol Int 2018;38:935–47. 10.1007/s00296-018-4005-5 - DOI - PMC - PubMed

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