Figure 1.

Study flow chart. Patients diagnosed with IRD will be invited by post and asked to return the prestudy screening questions. Screening is a two-step process using screening questions and review of medical records to establish fatigue state and identify other exclusion criteria. Potential participants will be contacted by phone to verify eligibility criteria and invited to the baseline assessment visit. After obtaining informed consent, their eligibility is confirmed (including fatigue states as well as determination of TSH, Hb and eGFR values if these were not available in the medical notes), baseline data are collected and participants are randomised into the study. At baseline, participants are also given a participant information sheet about the MRI substudy. Randomised participants will be contacted by the Trial Office in Aberdeen if they are also eligible to take part in the MRI substudy. CBA, cognitive-behavioural approach; eGFR, estimated glomerular filtration rate; Hb, haemoglobin; IRD, inflammatory rheumatic disease; PEP, personalised exercise programme; TSH, thyroid stimulating hormone.