Call for action: incorporating wellness practices into a holistic management plan for rheumatoid arthritis—going beyond treat to target

• Published in: RMD Open Vol. 7; no. 3; p. e001959
• Main Authors: Taylor, Peter C., Van de Laar, Mart, Laster, Andrew, Fakhouri, Walid, Quebe, Amanda, de la Torre, Inmaculada, Jain, Saundra
• Format: Journal Article Book Review
• Language: English
• Published: England EULAR 01.12.2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Review
• Subjects: Arthritis, Rheumatoid - drug therapy; autoimmune diseases; Cytokines; Diet; Disease; Exercise; Fatigue; Gene expression; Humans; Inflammation; Meditation; Mindfulness; Nutrition; Pain; patient care team; Patient Reported Outcome Measures; Patients; Physical fitness; physical therapy modalities; Polyphenols; Range of motion; Rheumatoid Arthritis; Sleep; Weight control; autoimmune diseases; patient care team; physical therapy modalities; rheumatoid arthritis
• ISSN: 2056-5933; 2056-5933
• DOI: 10.1136/rmdopen-2021-001959

This expert opinion article explores the strategy of adopting a holistic approach to the management of rheumatoid arthritis (RA) by incorporating the wellness practices of exercise, optimised sleep, optimised nutrition, mindfulness, social connectedness and positive emotions into the management plan. The aim is to attain optimal health for each patient beyond that achievable by limiting disease management to pharmacological treatment to attain the lowest achievable composite scores of disease activity, as recommended with the current treat-to-target approach, and addressing the recent recognition of pain control as a key patient-reported outcome. Incorporating wellness practices into a busy clinical setting requires creativity and customisation based on the individual practice setting and the individual needs of each patient. Such practices can help people living with RA to achieve optimum wellness through the introduction of measures—according to individual need—designed to improve the aspects of life most impacted for that person, thereby complementing treat-to-target and pain control strategies with pharmacological agents. Clinicians must consider wellness practices in addition to treat-to-target pharmacological agents for the holistic management of people with RA.