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Remotely delivered cognitive-behavioural and personalized exercise interventions to lessen the impact of fatigue: a qualitative evaluation

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LIFT study team , Sarah E Bennett, Celia Almeida, Eva-Maria Bachmair, Stuart R Gray, Karina Lovell, Lorna Paul, Alison Wearden, Gary J Macfarlane, Neil Basu, Emma Dures, Richard Emsley

Original languageEnglish
Article numberrkac051
JournalRheumatology Advances in Practice
Issue number2
Early online date27 Jun 2022
Accepted/In press13 Jun 2022
E-pub ahead of print27 Jun 2022
Published4 Jul 2022

Bibliographical note

Publisher Copyright: © 2022 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology.

King's Authors


Objectives: Fatigue can be a disabling symptom of inflammatory rheumatic diseases. LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomized Trial) is a randomized trial of remotely delivered cognitive-behavioural approach or personalized exercise programme interventions, compared with usual care. The aim of this nested qualitative study was to evaluate participants' experiences of taking part in the intervention, including their ideas about future service delivery.

Methods: Semi-structured telephone interviews were conducted with a subgroup of LIFT participants to discuss their views and experiences of the interventions.

Results: Forty-three participants (30 women) from six sites who had participated in the cognitive-behavioural approach (n = 22) or personalized exercise programme (n = 21) interventions took part. Five themes were identified in the thematic analysis. In the theme 'not a miracle cure, but a way to better manage fatigue', LIFT could not cure fatigue; however, most felt better able to manage after participating. Participants valued 'building a therapeutic relationship' with the same therapist throughout the intervention. In 'structure, self-monitoring and being accountable', participants liked the inclusion of goal-setting techniques and were motivated by reporting back to the therapist.After taking part in the interventions, participants felt 'better equipped to cope with fatigue'; more confident and empowered. Lastly, participants shared ideas for 'a tailored programme delivered remotely', including follow-up sessions, video calling, and group-based sessions for social support.

Conclusion: Many participants engaged with the LIFT interventions and reported benefits of taking part. This suggests an important future role for the remote delivery of fatigue self-management.

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