{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:36:10Z","timestamp":1790300170224,"version":"4.1.0"},"reference-count":49,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000142","name":"Arthritis Society","doi-asserted-by":"publisher","award":["20-001"],"award-info":[{"award-number":["20-001"]}],"id":[{"id":"10.13039\/501100000142","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,5,21]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To scope published reviews addressing fatigue in rheumatoid arthritis (RA), spondyloarthritis, osteoarthritis and fibromyalgia in areas relevant for clinical practice: (1) definition, (2) measurement instruments and diagnosis, (3) determinants, (4) consequences and (5) effectiveness of interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A systematic literature search of reviews was performed in five bibliographical databases. A hierarchical data extraction was applied based on review type (Cochrane reviews (CRs), followed by non-Cochrane systematic reviews (SRs) and narrative reviews (NRs)) and year of publication. Extracted data were summarised in elaborated narrative syntheses. Results were discussed with a patient panel.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One hundred and thirty-four reviews were included (19 CRs, 44 SRs, 71 NRs). No agreed on definition was reported for general fatigue, nor for types of fatigue. Twenty-five measurement instruments were found, all self-reported. Five instruments proposed a threshold for excessive fatigue. Pain, physical function and depressive symptoms were the most frequently studied disease-related determinants of fatigue; female sex and stress the most frequent contextual determinants. Work performance, followed by impact on pain, physical activity and social roles were the most frequently studied consequences. Whenever quantified, associations between fatigue with determinants and consequences were on average small. For non-pharmacological interventions, if effect sizes were reported, these were negligible to small and for pharmacological interventions negligible to moderate. Patients recommended actions for research and practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Syntheses of reviews point to the complexity of fatigue. The extensive amount of evidence could be used to offer tailored management plans to patients in clinical practice and inform future research agendas.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003056","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T12:33:37Z","timestamp":1691152417000},"page":"e003056","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Fatigue in patients with rheumatic and musculoskeletal diseases: a scoping review on definitions, measurement instruments, determinants, consequences and interventions"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1098-8908","authenticated-orcid":false,"given":"Esther","family":"Beckers","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8741-5484","authenticated-orcid":false,"given":"Kasper","family":"Hermans","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8477-0683","authenticated-orcid":false,"given":"Astrid","family":"Van Tubergen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-9533","authenticated-orcid":false,"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre+, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"2025090312390648000_9.3.e003056.1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1097\/BOR.0000000000000376","article-title":"Causes and consequences of fatigue in rheumatoid arthritis","volume":"29","author":"Katz","year":"2017","journal-title":"Curr Opin Rheumatol"},{"key":"2025090312390648000_9.3.e003056.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2010.05.002"},{"key":"2025090312390648000_9.3.e003056.3","doi-asserted-by":"publisher","DOI":"10.1002\/art.20910"},{"key":"2025090312390648000_9.3.e003056.4","doi-asserted-by":"crossref","unstructured":"Pilgaard T , Hagelund L , Stallknecht SE , et al . Severity of fatigue in people with rheumatoid arthritis, Psoriatic arthritis and Spondyloarthritis - results of a cross-sectional study. PLoS One 2019;14. doi:10.1371\/journal.pone.0218831","DOI":"10.1371\/journal.pone.0218831"},{"key":"2025090312390648000_9.3.e003056.5","unstructured":"ReumaNederland . Route23. 2022. Available: https:\/\/reumanederland.nl\/route23\/ [Accessed 5 Feb 2023]."},{"key":"2025090312390648000_9.3.e003056.6","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"Arksey","year":"2005","journal-title":"International Journal of Social Research Methodology"},{"key":"2025090312390648000_9.3.e003056.7","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"2025090312390648000_9.3.e003056.8","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"2025090312390648000_9.3.e003056.9","doi-asserted-by":"crossref","unstructured":"Higgins JPT , Thomas J , Chandler J , et al . Cochrane Handbook for systematic reviews of interventions. In: . 2nd Edition. Chichester (UK): John Wiley & Sons, 2019. doi:10.1002\/9781119536604","DOI":"10.1002\/9781119536604"},{"key":"2025090312390648000_9.3.e003056.10","unstructured":"World Health Organization . International classification of functioning, disability, and health (ICF). 2017. Available: https:\/\/www.who.int\/standards\/classifications\/international-classification-of-functioning-disability-and-health [Accessed 1 Nov 2021]."},{"key":"2025090312390648000_9.3.e003056.11","doi-asserted-by":"crossref","first-page":"487","DOI":"10.2217\/ijr.10.30","article-title":"Fatigue in rheumatic disease: an overview","volume":"5","author":"Stebbings","year":"2010","journal-title":"International Journal of Clinical Rheumatology"},{"key":"2025090312390648000_9.3.e003056.12","doi-asserted-by":"crossref","first-page":"1395","DOI":"10.3389\/fphys.2018.01395","article-title":"Perceived versus performance fatigability in patients with rheumatoid arthritis","volume":"9","author":"Marrelli","year":"2018","journal-title":"Front Physiol"},{"key":"2025090312390648000_9.3.e003056.13","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1016\/j.jpainsymman.2019.12.358","article-title":"A qualitative Metasynthesis of the experience of fatigue across five chronic conditions","volume":"59","author":"Jaime-Lara","year":"2020","journal-title":"J Pain Symptom Manage"},{"key":"2025090312390648000_9.3.e003056.14","doi-asserted-by":"publisher","DOI":"10.1186\/ar4395"},{"issue":"Suppl 10","key":"2025090312390648000_9.3.e003056.15","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/acr.24246","article-title":"Measures of fatigue in patients with rheumatic diseases: A critical review","volume":"72 Suppl 10","author":"Elera-Fitzcarrald","year":"2020","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090312390648000_9.3.e003056.16","first-page":"2281","article-title":"A new approach to defining functional ability in Ankylosing Spondylitis: the development of the bath Ankylosing Spondylitis functional index","volume":"21","author":"Calin","year":"1994","journal-title":"J Rheumatol"},{"key":"2025090312390648000_9.3.e003056.17","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2014-205207"},{"key":"2025090312390648000_9.3.e003056.18","doi-asserted-by":"publisher","DOI":"10.1186\/ar2783"},{"key":"2025090312390648000_9.3.e003056.19","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.142901"},{"key":"2025090312390648000_9.3.e003056.20","doi-asserted-by":"crossref","unstructured":"Regnaux J-P , Davergne T , Palazzo C , et al . Exercise programmes for Ankylosing Spondylitis. Cochrane Database Syst Rev 2019;10. doi:10.1002\/14651858.CD011321.pub2","DOI":"10.1002\/14651858.CD011321.pub2"},{"key":"2025090312390648000_9.3.e003056.21","doi-asserted-by":"crossref","unstructured":"Almeida C , Choy EHS , Hewlett S , et al . Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev 2013;8. doi:10.1002\/14651858.CD008322.pub2","DOI":"10.1002\/14651858.CD008322.pub2"},{"key":"2025090312390648000_9.3.e003056.22","doi-asserted-by":"crossref","unstructured":"Almeida C , Choy EHS , Hewlett S , et al . Biologic interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev 2016. doi:10.1002\/14651858.CD008334.pub2","DOI":"10.1002\/14651858.CD008334.pub2"},{"key":"2025090312390648000_9.3.e003056.23","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker162"},{"key":"2025090312390648000_9.3.e003056.24","first-page":"87","article-title":"The impact of Tocilizumab on physical function and quality of life in patients with rheumatoid arthritis: a systematic literature review and interpretation","volume":"4","author":"Townes","year":"2012","journal-title":"Open Access Rheumatol"},{"key":"2025090312390648000_9.3.e003056.25","doi-asserted-by":"crossref","unstructured":"Atzeni F , Nucera V , Masala IF , et al . Il-6 involvement in pain, fatigue and mood disorders in rheumatoid arthritis and the effects of Il-6 inhibitor Sarilumab. Pharmacol Res 2019;149. doi:10.1016\/j.phrs.2019.104402","DOI":"10.1016\/j.phrs.2019.104402"},{"issue":"Suppl 5","key":"2025090312390648000_9.3.e003056.26","doi-asserted-by":"crossref","first-page":"v51","DOI":"10.1093\/rheumatology\/kez389","article-title":"Effect of Biologics and targeted synthetic disease-modifying anti-rheumatic drugs on fatigue in rheumatoid arthritis","volume":"58","author":"Choy","year":"2019","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312390648000_9.3.e003056.27","doi-asserted-by":"publisher","DOI":"10.1517\/14712598.4.8.1333"},{"key":"2025090312390648000_9.3.e003056.28","doi-asserted-by":"crossref","unstructured":"Pope JE . Management of fatigue in rheumatoid arthritis. RMD Open 2020;6. doi:10.1136\/rmdopen-2019-001084","DOI":"10.1136\/rmdopen-2019-001084"},{"key":"2025090312390648000_9.3.e003056.29","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00482-015-0084-3","article-title":"Efficacy, tolerability and safety of Cannabinoids in chronic pain associated with rheumatic diseases (Fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis): A systematic review of randomized controlled trials","volume":"30","author":"Fitzcharles","year":"2016","journal-title":"Schmerz"},{"key":"2025090312390648000_9.3.e003056.30","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1007\/s40265-019-01091-3","article-title":"Tofacitinib: A review in Psoriatic arthritis","volume":"79","author":"Paik","year":"2019","journal-title":"Drugs"},{"key":"2025090312390648000_9.3.e003056.31","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-017-0709-1"},{"key":"2025090312390648000_9.3.e003056.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.annrmp.2006.03.007"},{"key":"2025090312390648000_9.3.e003056.33","doi-asserted-by":"crossref","unstructured":"Welsch P , Bernardy K , Derry S , et al . Mirtazapine for Fibromyalgia in adults. Cochrane Database Syst Rev 2018;8. doi:10.1002\/14651858.CD012708.pub2","DOI":"10.1002\/14651858.CD012708.pub2"},{"key":"2025090312390648000_9.3.e003056.34","doi-asserted-by":"crossref","unstructured":"Welsch P , \u00dc\u00e7eyler N , Klose P , et al . Serotonin and noradrenaline reuptake inhibitors (Snris) for Fibromyalgia. Cochrane Database Syst Rev 2018;2. doi:10.1002\/14651858.CD010292.pub2","DOI":"10.1002\/14651858.CD010292.pub2"},{"key":"2025090312390648000_9.3.e003056.35","doi-asserted-by":"crossref","unstructured":"Walitt B , Urr\u00fatia G , Nishishinya MB , et al . Selective serotonin reuptake inhibitors for Fibromyalgia syndrome. Cochrane Database Syst Rev 2015. doi:10.1002\/14651858.CD011735","DOI":"10.1002\/14651858.CD011735"},{"key":"2025090312390648000_9.3.e003056.36","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.944"},{"key":"2025090312390648000_9.3.e003056.37","doi-asserted-by":"crossref","unstructured":"Thorpe J , Shum B , Moore RA , et al . Combination Pharmacotherapy for the treatment of Fibromyalgia in adults. Cochrane Database Syst Rev 2018;2018. doi:10.1002\/14651858.CD010585.pub2","DOI":"10.1002\/14651858.CD010585.pub2"},{"key":"2025090312390648000_9.3.e003056.38","doi-asserted-by":"crossref","unstructured":"Walitt B , Klose P , \u00dc\u00e7eyler N , et al . Antipsychotics for Fibromyalgia in adults. Cochrane Database Syst Rev 2016;2016. doi:10.1002\/14651858.CD011804.pub2","DOI":"10.1002\/14651858.CD011804.pub2"},{"key":"2025090312390648000_9.3.e003056.39","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.ctim.2019.01.022","article-title":"Effect of coenzyme Q10 supplementation on fatigue: a systematic review of Interventional studies","volume":"43","author":"Mehrabani","year":"2019","journal-title":"Complement Ther Med"},{"key":"2025090312390648000_9.3.e003056.40","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1586\/17512433.2016.1145052","article-title":"Novel pharmaceutical options for treating Fibromyalgia","volume":"9","author":"Gerardi","year":"2016","journal-title":"Expert Rev Clin Pharmacol"},{"key":"2025090312390648000_9.3.e003056.41","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(01)00007-2"},{"key":"2025090312390648000_9.3.e003056.42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2165\/11530950-000000000-00000","article-title":"Pharmacological treatment of Fibromyalgia syndrome: new developments","volume":"70","author":"Staud","year":"2010","journal-title":"Drugs"},{"key":"2025090312390648000_9.3.e003056.43","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1517\/14656566.2011.589836","article-title":"Sodium Oxybate for the treatment of Fibromyalgia","volume":"12","author":"Staud","year":"2011","journal-title":"Expert Opin Pharmacother"},{"key":"2025090312390648000_9.3.e003056.44","doi-asserted-by":"crossref","unstructured":"Walrabenstein W , Wagenaar CA , van der Leeden M , et al . A Multidisciplinary lifestyle program for rheumatoid arthritis: the \"plants for joints\" Rheumatology (Oxford) 2023. doi:10.1093\/rheumatology\/keac693","DOI":"10.1093\/rheumatology\/keac693"},{"key":"2025090312390648000_9.3.e003056.45","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215803"},{"key":"2025090312390648000_9.3.e003056.46","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.091454"},{"key":"2025090312390648000_9.3.e003056.47","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-021-00692-1"},{"key":"2025090312390648000_9.3.e003056.48","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq282"},{"key":"2025090312390648000_9.3.e003056.49","doi-asserted-by":"publisher","DOI":"10.1002\/art.20076"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003056","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:39:17Z","timestamp":1756928357000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003056"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,8,4]]},"published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1136\/rmdopen-2023-003056"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003056","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8]]}}}