The co-creation of a COMbined Fatigue Intervention (COMFI) for people with inflammatory arthritis: a complex intervention.

OBJECTIVES

To develop a group-based COMbined Fatigue Intervention (COMFI) that integrates a cognitive behavioural approach with physical activity to enhance self-management of fatigue and reduce fatigue severity and impact in people with inflammatory arthritis (IA).

METHODS

The development was guided by the British Medical Research Council's framework for complex interventions and was based on: (i) the identification of current evidence, (ii) selection of relevant theories, (iii) iterative modelling and refinement through 4 co-creation workshops with relevant stakeholders (patient research partners, patients, relatives, healthcare professionals, and researchers); and (iv) development of a manual for healthcare professionals. COMFI was developed across units in Denmark and Sweden.

RESULTS

The development resulted in a 24-week group-based fatigue intervention comprising of: (i) six group sessions delivered over 12 weeks, (ii) a seventh booster session at week 24, (iii) 1 optional individual session, (iv) a support telephone line during weeks 13 to 23, and (v) optional involvement of relatives in session 1 and 6. The intervention integrates the cognitive behavioural approach Focused Acceptance and Commitment Therapy and physical activity.

CONCLUSION

COMFI is a novel co-created evidence-based intervention designed to support self-management of fatigue in people with IA. COMFI is ready for feasibility testing in Denmark and Sweden.