Table 1.

EULAR overarching principles (OAPs) and recommendations for the implementation of self-management strategies in patients with inflammatory arthritis (IA)

	LoE (1–5)	SoR (A–D)	Level of agreement (0–10)
			Mean (SD)	% with score ≥8
OAPs
A. Self-management implies taking an active role in learning about one’s condition and in the shared decision-making process about one’s health and care pathway.	n.a	n.a	9.5 (0.6)	100
B. Self-efficacy (personal confidence to carry out an activity with the aim of achieving a desired outcome) has a positive effect on various aspects of living with IA.	n.a	n.a	9.6 (0.7)	100
C. Patient organisations often provide valuable self-management resources and collaboration between healthcare professionals (HCPs) and patient organisations will therefore benefit patients.	n.a	n.a	9.4 (1.0)	88
Recommendations
R1. HCPs should encourage patients to become active partners of the team and make them aware of HCPs and patient organisations involved in all aspects of the care pathway.	5	D	9.5 (1.1)	87
R2. Patient education should be the start point and underpin all self-management interventions.	1A	A	9.5 (0.8)	93
R3. Self-management interventions that include problem solving and goal setting and, where relevant to the individual and available, cognitive behavioural therapy should be incorporated into routine clinical practice to support patients.	1A	A	9.1 (1.4)	93
R4. HCPs should actively promote physical activity at diagnosis and throughout the disease course.	1A	A	9.9 (0.3)	100
R5. Lifestyle advice based on evidence should be given to better manage common comorbidity and patients should be guided and encouraged by their healthcare team to adopt healthy behaviours.	5	D	9.6 (0.6)	100
R6. Better emotional well-being leads to better self-management; therefore, mental health needs to be assessed periodically and appropriate intervention should be made if necessary.	5	D	9.4 (1.3)	93
R7. HCPs should invite discussion with patients about work and signpost to sources of help where appropriate or where needed.	5	D	9.6 (0.5)	100
R8. Digital healthcare can help patients to self-manage and should be considered for inclusion in supported self-management where appropriate and available.	1B	A	9.3 (1.0)	93
R9. HCPs should make themselves aware of available resources to signpost patients to, as part of optimising and supporting self-management.	5	D	8.7 (1.2)	100

EULAR, European Alliance of Associations for Rheumatology; LoE, level of evidence (1–5; 1 indicating evidence from high-quality randomised clinical trial (RCT) data and 5 indicating evidence from expert opinion without explicit critical appraisal or based on physiology, bench research or ‘first principles’)¹¹; n.a, not applicable; SoR, strength of recommendation (A–D; A indicating consistent level 1 studies (RCTs) and D indicating level 5 evidence or troublingly inconsistent or inconclusive studies of any level).