EULAR task force promotes patient-centered framework, personalized management The European League Against Rheumatism (EULAR) convened a multidisciplinary task force to develop evidence-based recommendations for pain management in patients with inflammatory arthritis (IA) and osteoarthritis (OA). After a systematic literature review of the evidence regarding multi-modal pain management, the task force, which included health professionals and patient representatives, summarized their findings as overarching principles and recommendations. Treatment is guided by scientific evidence and the assessment of patient needs, preferences and priorities; these recommendations enable health professionals to provide knowledgeable pain-management support for people with IA and OA. Overarching Principles The assessment and treatment process should be guided by a patient-centered framework. The health professional should understand that (any type of) pain encompasses multiple and mutually interacting biological, psychological, and social factors. The health professional should have basic knowledge of the pathology, treatment and sequelae of IA and OA. The health professional should be able to differentiate between localized and generalized pain, and should know that these types of pain may coexist. Recommendations for Pain Management Assessment by the health professional can be brief or extensive depending on factors such as available time, whether it is a first or regular consultation, and the needs of the patient. The patient should receive a personalized management plan with the aim of reducing pain. and pain-related distress, as well as improving pain-related function and participation in daily life. This plan is guided by shared decision-making, the expressed needs of the patient, the health professional's assessment, and evidence-based treatment options. A stepped-care approach was proposed. The patient should receive education. If indicated, the patient should receive physical activity and exercise, orthotics, psychological or social interventions, sleep interventions, or weight management. If indicated, the patient should receive pharmacological and joint-specific pain treatment according to recent recommendations. If indicated, the patient should receive multidisciplinary treatment. These overarching principles and recommendations regarding assessment are based on expert opinion. Source
