2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis (Part  2)

We now discuss the methods used in the crafting of the 2021 European Alliance of Associations for Rheumatology (EULAR) guidelines. We need to establish first that the 2014 standardized operating procedures were extensively referenced in the crafting of the 2021 guidelines for the management of inflammatory arthritis (IA).
The EULAR formed a task force composed of.18 members coming from different countries across the European continent.
Task force members came with a background and expertise in rheumatology, nursing, occupational therapy, psychology, self-management, exercise physiology and physiotherapy.
The task force membership also included patient representatives with experience of having IA.

Expert discussions took place primarily through 2 meetings: the first one was face-to-face and the 2nd meeting was online.
Before the 1st meeting, an initial review and a survey were undertaken to look into the interventions in IA and self-managementresources in rheumatic and musculoskeletal disease (RMD).
During the 1st meeting, the scope of work, definitions for self-management and overarching principles (OAPs) were
considered.

Furthermore,  the needs and key clinically relevant questions were sorted out in relation to self-management in IA. The sourcesof best practices were given a long hard look.
To prepare for the 2nd meeting, which was guided by the 1st meeting, clinical questions were converted by the steering group into epidemiological questions. The questions were addressed through systematic literature review (SLR) undertaken by the task force fellows.
The goal of the SLR was to identify the best evidence for the implementation of self-management interventions in IA. The SLR also aimed to identify components and effects.
The SLR was conducted based in the Cochrane Handbook and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Patient organisations affiliated with EULAR and health care
professionals (HCP) across Europe were consulted via direct email communication. Information were asked from them, including their experience obtained from the SLR.
At the 2nd meeting, the task force members crafted the OAPs and recommendations based on data from the SLR, survey, information from the patients, HCPs and best practices,expert opinion, discussion and voting.

We will continue our discussion on the methodology that was used in the formulation of the guidelines in next week’s column.