Non-pharmacological interventions for the management of fatigue and constitutional symptoms in Sjogren's syndrome

Current treatments for Sjögren’s syndrome (SS) are limited. Pharmacological treatments tend to focus on topical treatments for dryness or oral muscarinic agonists which increase tear production and salivary flow. National treatment guidelines for primary SS incorporating available published evidence and expert opinion include recommendations for specific pharmacological topical and systemic treatments. However, despite the availability of such treatments, SS patients still experience symptoms, difficulties performing their daily activities, and reduced quality of life. This chapter explores specific ways nonpharmacological support for patients with primary SS might be delivered. These include the provision of information and patient education, as well as specific symptom management support for anxiety, sleep disturbances, pain, discomfort, low mood, and anxiety. Possible modes of delivering interventions and consideration of the differing levels of support which are required for different patients are also discussed.