How do we perceive activity pacing in rheumatology care? An international delphi survey

Cuperus, N; Vliet Vlieland, TPM; Brodin, N; Hammond, A; Kjeken, I; Lund, H; Murphy, S; Neijland, Y; Opava, C; Roskar, S; Sargautye, R; Stamm, T; Torres Mata, X; Uhlig, T; Zangi, H; van der Ende, CH

Abstract

Background Activity pacing is a recommended non-pharmacological intervention for the management of rheumatic and musculoskeletal diseases in international clinical guidelines. In clinical practice, activity pacing aims at adapting daily activities, and is often an important component of self-management programs. However, despite its wide endorsement in clinical practice, to date activity pacing is still a poorly understood concept.
Objectives To achieve consensus by means of an international Delphi exercise on the most important aspects of activity pacing as an intervention within non-pharmacological rheumatology care.
Methods An international, multidisciplinary expert panel comprising 60 clinicians and/or healthcare providers experienced with activity pacing across 12 different countries participated in a Delphi survey. Over four Delphi rounds, the panelists identified and ranked the most important goals of activity pacing, behaviours of activity pacing (the actions people take to meet the goal of activity pacing), strategies to change behaviour in activity pacing (for example goal setting) and contextual factors that should be acknowledged when instructing activity pacing. Besides, topics for future research on activity pacing were formulated and prioritized.
Results Of the 60 panelists, nearly two third (63%) completed all four Delphi rounds. The panel prioritized 9 goals, 11 behaviours, 9 strategies to change behaviour and 10 contextual factors of activity pacing. These items were integrated into a consensual list containing the most important aspects of activity pacing interventions in non-pharmacological rheumatology care. Furthermore, the Delphi panel prioritized 9 topics for future research on activity pacing which were included in a research agenda. This agenda highlights that future research should focus on the effectiveness of activity pacing interventions and on appropriate outcome measures to assess its effectiveness, as selected by 64% and 82% of the panelists, respectively.
Conclusions The diversity and number of items included in the consensual list developed in the current study reflect the heterogeneity of the concept of activity pacing. This study is an important first step to achieve better transparency and homogeneity within the concept of activity pacing for clinical practice and research.

• Journal Article Type: Article
• Acceptance Date: Apr 1, 2015
• Publication Date: Jun 9, 2015
• Deposit Date: Mar 22, 2016
• Publicly Available Date: Mar 22, 2016
• Journal: Annals of the Rheumatic Diseases (ARD)
• Print ISSN: 0003-4967
• Electronic ISSN: 1468-2060
• Publisher: BMJ Publishing Group
• Volume: 74
• Issue: Suppl2
• Pages: 159
• DOI: https://doi.org/10.1136/annrheumdis-2015-eular.2556
• Publisher URL: http://dx.doi.org/10.1136/annrheumdis-2015-eular.2556
• Related Public URLs: http://ard.bmj.com