Reducing Arthritis Fatigue: Team cognitive-behavioural approach (RAFT)
Research type
Research Study
Full title
Reducing Arthritis Fatigue – clinical Teams using cognitive behavioural approaches (RAFT)\n
IRAS ID
137660
Contact name
Sarah Hewlett
Contact email
Sponsor organisation
Research and Innovation, United Hospitals Bristol
Research summary
Rheumatoid Arthritis (RA) is a lifelong inflammatory condition, leading to joint damage and disability. Up to 70% of people with RA experience fatigue on most days, which is much worse than normal tiredness and as severe as RA pain. Patients don’t know how to manage their fatigue, and report clinical staff don’t help. \n\nRA fatigue may be caused by combinations of inflammation, pain, disability, depression, stress, poor sleep, and behaviour. There are links between people’s beliefs, feelings, behaviours and symptoms, eg someone who believes that housework must be done perfectly, feeling guilty if it is not, often overworks, causing fatigue. In Cognitive Behavioural Therapy (CBT), psychologists use reflective questioning to help patients identify these links, and so help them change behaviours. We tested a CBT course to help people manage RA fatigue, led by a psychologist, which improved fatigue impact, severity and coping; mood, sleep and disability. However, few rheumatology teams have psychologists, therefore we will test whether rheumatology nurses or occupational therapists (OTs) (tutors) could be trained to deliver this course. We successfully piloted RAFT - Reducing Arthritis Fatigue: Teams using cognitive behavioural approaches. \n\nAfter training, 2 local rheumatology tutors in 7 hospitals will deliver 4 RAFT courses, each to groups of 5-7 patients. A course comprises 7 sessions (2 hours/week for weeks 1-6, consolidation session week 14). 300 patients with RA fatigue will be assigned randomly (by chance) to either ‘usual care’ plus a RAFT course, or ‘usual care’ alone (Arthritis Research UK Fatigue self-management booklet). We will assess change in fatigue impact, severity and coping; pain, disability, mood, sleep, quality of life, and valued activities over 2 years, plus the cost/savings to the NHS. Eventually, RAFT will be copyrighted, with free licensed use across the NHS and a local CBT practitioner will support local rheumatology tutors.
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
13/EE/0310
Date of REC Opinion
25 Sep 2013
REC opinion
Further Information Favourable Opinion