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Background: Fatigue is one of the most debilitating and burdensome symptoms of inflammatory arthritis. It is a key contributor to loss of employment and exacerbating other symptoms of inflammatory arthritis. Although fatigue is commonly reported as a debilitating symptom; it is rarely discussed as a treatment target. Objectives: This study aimed to understand the perspectives of occupational therapists specializing in rheumatology and rheumatology physicians regarding the referral of patients to a fatigue management intervention and delivering an online Fatigue and Activity Management for Work (FAME-W) intervention for individuals with inflammatory arthritis. Methods: A qualitative descriptive design was used, involving semi-structured interviews conducted with occupational therapists and rheumatologists. Clinicians were interviewed on their views about delivering FAME-W, the importance and need of fatigue management education, fatigue discussions during clinics with the patient and the tools clinicians have to support patients with fatigue. Data were analysed by thematic analysis (Braun and Clark, 2021). Results: Five occupational therapists specializing in rheumatology and two rheumatology physicians were interviewed. On average, the interviews had a duration of eighteen minutes. Three themes were identified. In the first theme "Discussions on Fatigue with Patients" rheumatology physicians reported being hesitant to bring up fatigue during clinics. In contrast, occupational therapists view fatigue assessment and education as standard practice. Moreover, physicians reported that they refrain from initiating discussions on fatigue when there is no intervention to offer patients, such as a fatigue management education programme. The second theme "Need for Fatigue Management Education Interventions" reported that occupational therapists and rheumatology physicians agreed on the need for fatigue management interventions for individuals with inflammatory arthritis; however, they found it difficult to allocate clinical time to fatigue management alone. In the third theme "Programme Recruitment" it was reported that a multidisciplinary team is needed to recruit patients to run a programme. Occupational therapists reported that although fatigue management is a core aspect of routine clinical interventions, a specialized group-based intervention is preferable for peer support and to maximize clinical efficiency. Conclusion: Rheumatology physicians and occupational therapists understand the importance of discussing fatigue during clinic visits. However, it appears that perhaps rheumatology clinicians do not have the resources to offer fatigue management interventions. Therefore, a multidisciplinary team is required to develop clear fatigue management clinical pathways to help patients manage fatigue. REFERENCES: 1 Braun, V., & Clarke, V. (2022). Conceptual and design thinking for thematic analysis. Qualitative Psychology, 9(1), 3-26. https://doi.org/10.1037/qup0000196. Acknowledgements: NIL. Disclosure of Interests: None declared.
Karkon et al. (Sat,) studied this question.