STRATEGIES addressing fatigue, lived experiences of caregivers, cost-effectiveness of patient education, and access to rheumatology care were presented today at EULAR 2026, London, UK, in a bid to improve the quality of life of patients with rheumatic and musculoskeletal diseases (RMD).
RMDs profoundly impact daily life, limiting both work ability and participation in everyday activities.
Fatigue
Fatigue is a common and burdensome symptom for people with inflammatory arthritis.1
Whilst tailored physical activity and cognitive behavioural approaches are known to help, little is known about the impact of combining the two.
At EULAR 2026, Astrid Damgaard presented findings from a feasibility study involving 29 patients with inflammatory arthritis in Denmark and Sweden.
The research team found that the COMbined Fatigue Intervention (COMFI),2 a strategy designed to integrate the two effective approaches, could be delivered successfully in both countries.
After a follow-up period of six months, results indicated a tendency toward reduced fatigue, with observed changes meeting the minimal clinically important difference in both countries in all fatigue measurements, including the subscales for fatigue severity, impact, and coping.
Authors concluded that the approach was feasible to deliver to people with inflammatory arthritis and fatigue.
Caregiver Experiences
RMD management also often requires sustained support from caregivers to enable daily functioning.
Speaking today at EULAR 2026, Rikke Helene Moe, Vice-President of Health Professionals in Rheumatology, EULAR, Kilchberg, Switzerland, told reporters: “We are maybe not so good at including patient families, and doing research on how their disease and management affects the family.”
She pointed to an Italian phenomenological study presented at EULAR, in which researchers examined the lived experiences of 25 family members and primary informal caregivers.
Moe explained: “They interviewed 25 caregivers, mostly spouses and partners, and they described that they experience emotional distress, feelings of helplessness, and guilt that was difficult to handle.”
At the onset of illness, many people reported difficult choices and compromises, with 26.7% citing major life changes or sacrifices and 52% reporting predominantly negative emotions, including sadness, anxiety, fatigue, and emotional overload.
The development of caregiver-focused assessments and tailored psychosocial and educational interventions may reportedly improve their wellbeing, enhance patient outcomes, and support more holistic and person-centred care.
Diagnostic Delays
Also among patient experience obstacles cited at EULAR 2026 was diagnostic delays.
For example, there is a global mean delay to diagnosis for axial spondyloarthritis (axSpA) of 7.4 years.3
A team in Canada presented preliminary results from the FASTRAX study, trialling an interdisciplinary model to improve access to rheumatology care and promote early identification.
The approach leverages trained extended scope providers and rheumatology fellows to quickly screen patients with chronic low back pain.
To date, 179 patients have completed the screening process across three study sites with a median wait time to assessment of 28 days.
Of those, 22.9% were diagnosed with axSpA, with a mean time to diagnosis of 12.1 years.
Overall, the number needed to screen across the province was five patients with chronic back pain to identify one patient with axSpA, with some variation across sties.
Notably, however, historically axSpA represents approximately 5% of those with chronic back pain, suggesting a need to screen approximately 20 people to detect one axSpA case.4
Lead author Laura Passalent, University of Toronto, Ontario, Canada, said: “The model is valid and delivers quick access to care, with referral wait times much less than the provincial median.
“Time to diagnosis remains prolonged, but this is expected to decrease as the model gains awareness amongst referring physicians and matures over time, allowing for more targeted rheumatology referrals.”
References
1 Dures E et al. Fatigue in inflammatory arthritis. Best Pract Res Clin Rheumatol. 2020;34(2):101526.
2 Skivington K et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. Int J Nurs Stud 2024;154:104705.
3 Poddubnyy D et al. Diagnostic delay in patients from the International Map of Axial Spondyloarthritis: geographic, sociodemographic and disease-related factors. Rheumatology (Oxford) 2025;64(4):1873–9.
4 Reveille JD et al. Prevalence of axial spondylarthritis in the United States: estimates from a cross-sectional survey. Arthritis Care Res (Hoboken) 2012;64(6):905–10.
Featured image: littlewolf1989 on Adobe Stock
