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Management of fatigue with physical activity and behavioural change support in vasculitis: A feasibility study

Harper, Lorraine; Hewitt, Catherine A; Litchfield, Ian; Morgan, Matthew D; Chanouzas, Dimitrios; Caulfield, Hollie K; Coughlan, Linda; Dean, Caroline; Fletcher, Kate; Cramp, Fiona; Greenfield, Sheila; Ives, Natalie J; Jowett, Sue; Kodabuckus, Shalela; Tearne, Sarah; Sehmi, Sukhwant; Edwardson, Charlotte; Dawkins, Nathan P; Daley, Amanda J

Authors

Lorraine Harper

Catherine A Hewitt

Ian Litchfield

Matthew D Morgan

Dimitrios Chanouzas

Hollie K Caulfield

Linda Coughlan

Caroline Dean

Kate Fletcher

Fiona Cramp Fiona.Cramp@uwe.ac.uk
Professor in Long Term Conditions

Sheila Greenfield

Natalie J Ives

Sue Jowett

Shalela Kodabuckus

Sarah Tearne

Sukhwant Sehmi

Charlotte Edwardson

Nathan P Dawkins

Amanda J Daley



Abstract

Objective
Patients with ANCA associated vasculitis (AAV) experience high levels of fatigue, despite disease remission. This study assessed the feasibility and acceptability of a definitive randomised controlled trial of a behaviourally based physical activity intervention to support fatigue self-management in AAV patients.

Methods
AAV patients in disease remission with fatigue (Multidimensional Fatigue Inventory-20 general fatigue domain≥14) were randomly allocated to intervention or standard care in this single-centre open-label randomised controlled feasibility study. The intervention lasted 12 weeks and comprised eight face-to-face physical activity sessions with a facilitator and 12 weekly telephone calls. Participants were encouraged to monitor their physical activity using a tracker device (Fitbit). Standard care involved sign-posting to fatigue websites. The primary outcome was feasibility of a phase III trial assessed against three stop-go traffic light criteria, (recruitment, adherence to the intervention and study withdrawal). A qualitative study assessed participant views about the intervention.

Results
248 patients were screened and 134 were eligible to participate (54%). Stop-go criteria were amber for recruitment; 43/134 (32%, 95% CI 24-40) eligible participants randomised, amber for adherence; 73% of participants attended all eight physical activity sessions, but only 11/22 (50%, 95% CI 29-71%) completed the intervention as per the intended schedule, and green for study withdrawal; 2/43 participants withdrew before 24 weeks (5%, 95% CI 0-11). Qualitative results suggested the intervention was acceptable.

Conclusion
This study suggests a behaviour based physical activity intervention targeting fatigue self-management was acceptable to patients with AAV, although recruitment and protocol adherence will need modification prior to a definitive trial.

Citation

Harper, L., Hewitt, C. A., Litchfield, I., Morgan, M. D., Chanouzas, D., Caulfield, H. K., …Daley, A. J. (in press). Management of fatigue with physical activity and behavioural change support in vasculitis: A feasibility study. Rheumatology, https://doi.org/10.1093/rheumatology/keaa890

Journal Article Type Article
Acceptance Date Nov 24, 2020
Online Publication Date Jan 22, 2021
Deposit Date Dec 2, 2020
Publicly Available Date Jan 23, 2022
Journal Rheumatology
Print ISSN 1462-0324
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Article Number keaa890
DOI https://doi.org/10.1093/rheumatology/keaa890
Keywords physical activity, health behaviour change, fatigue, rheumatic disease
Public URL https://uwe-repository.worktribe.com/output/6915493