research introduction about time management

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Open Access

Peer-reviewed

Research Article

Does time management work? A meta-analysis

Roles Conceptualization, Data curation, Formal analysis, Methodology, Software, Validation, Writing – original draft, Writing – review & editing

* E-mail: [email protected]

Affiliation Concordia University, Sir George Williams Campus, Montreal, Quebec, Canada

Roles Methodology, Validation

Affiliation FSA Ulaval, Laval University, Quebec City, Quebec, Canada

Roles Validation, Writing – review & editing

• Brad Aeon, 
• Aïda Faber, 
• Alexandra Panaccio

• Published: January 11, 2021
• https://doi.org/10.1371/journal.pone.0245066
• Reader Comments

Does time management work? We conducted a meta-analysis to assess the impact of time management on performance and well-being. Results show that time management is moderately related to job performance, academic achievement, and wellbeing. Time management also shows a moderate, negative relationship with distress. Interestingly, individual differences and contextual factors have a much weaker association with time management, with the notable exception of conscientiousness. The extremely weak correlation with gender was unexpected: women seem to manage time better than men, but the difference is very slight. Further, we found that the link between time management and job performance seems to increase over the years: time management is more likely to get people a positive performance review at work today than in the early 1990s. The link between time management and gender, too, seems to intensify: women’s time management scores have been on the rise for the past few decades. We also note that time management seems to enhance wellbeing—in particular, life satisfaction—to a greater extent than it does performance. This challenges the common perception that time management first and foremost enhances work performance, and that wellbeing is simply a byproduct.

Citation: Aeon B, Faber A, Panaccio A (2021) Does time management work? A meta-analysis. PLoS ONE 16(1): e0245066. https://doi.org/10.1371/journal.pone.0245066

Editor: Juan-Carlos Pérez-González, Universidad Nacional de Educacion a Distancia (UNED), SPAIN

Received: October 27, 2020; Accepted: December 21, 2020; Published: January 11, 2021

Copyright: © 2021 Aeon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist

Introduction

Stand-up comedian George Carlin once quipped that in the future a “time machine will be built, but no one will have time to use it” [ 1 ]. Portentously, booksellers now carry one-minute bedtime stories for time-starved parents [ 2 ] and people increasingly speed-watch videos and speed-listen to audio books [ 3 – 5 ]. These behaviors are symptomatic of an increasingly harried society suffering from chronic time poverty [ 6 ]. Work is intensifying—in 1965 about 50% of workers took breaks; in 2003, less than 2% [ 7 ]. Leisure, too, is intensifying: people strive to consume music, social media, vacations, and other leisure activities ever more efficiently [ 8 – 11 ].

In this frantic context, time management is often touted as a panacea for time pressure. Media outlets routinely extol the virtues of time management. Employers, educators, parents, and politicians exhort employees, students, children, and citizens to embrace more efficient ways to use time [ 12 – 16 ]. In light of this, it is not surprising that from 1960 to 2008 the frequency of books mentioning time management shot up by more than 2,700% [ 17 ].

Time management is defined as “a form of decision making used by individuals to structure, protect, and adapt their time to changing conditions” [ 18 ]. This means time management, as it is generally portrayed in the literature, comprises three components: structuring, protecting, and adapting time. Well-established time management measures reflect these concepts. Structuring time, for instance, is captured in such items as “Do you have a daily routine which you follow?” and “Do your main activities during the day fit together in a structured way?” [ 19 ]. Protecting time is reflected in items such as “Do you often find yourself doing things which interfere with your schoolwork simply because you hate to say ‘No’ to people?” [ 20 ]. And adapting time to changing conditions is seen in such items as “Uses waiting time” and “Evaluates daily schedule” [ 21 ].

Research has, furthermore, addressed several important aspects of time management, such as its relationship with work-life balance [ 22 ], whether gender differences in time management ability develop in early childhood [ 23 ], and whether organizations that encourage employees to manage their time experience less stress and turnover [ 24 ]. Despite the phenomenal popularity of this topic, however, academic research has yet to address some fundamental questions [ 25 – 27 ].

A critical gap in time management research is the question of whether time management works [ 28 , 29 ]. For instance, studies on the relationship between time management and job performance reveal mixed findings [ 30 , 31 ]. Furthermore, scholars’ attempts to synthesize the literature have so far been qualitative, precluding a quantitative overall assessment [ 18 , 32 , 33 ]. To tackle this gap in our understanding of time management, we conducted a meta-analysis. In addressing the question of whether time management works, we first clarify the criteria for effectiveness. In line with previous reviews, we find that virtually all studies focus on two broad outcomes: performance and wellbeing [ 32 ].

Overall, results suggest that time management enhances job performance, academic achievement, and wellbeing. Interestingly, individual differences (e.g., gender, age) and contextual factors (e.g., job autonomy, workload) were much less related to time management ability, with the notable exception of personality and, in particular, conscientiousness. Furthermore, the link between time management and job performance seems to grow stronger over the years, perhaps reflecting the growing need to manage time in increasingly autonomous and flexible jobs [ 34 – 37 ].

Overall, our findings provide academics, policymakers, and the general audience with better information to assess the value of time management. This information is all the more useful amid the growing doubts about the effectiveness of time management [ 38 ]. We elaborate on the contributions and implications of our findings in the discussion section.

What does it mean to say that time management works?

In the din of current debates over productivity, reduced workweeks, and flexible hours, time management comes to the fore as a major talking point. Given its popularity, it would seem rather pointless to question its effectiveness. Indeed, time management’s effectiveness is often taken for granted, presumably because time management offers a seemingly logical solution to a lifestyle that increasingly requires coordination and prioritization skills [ 39 , 40 ].

Yet, popular media outlets increasingly voice concern and frustration over time management, reflecting at least part of the population’s growing disenchantment [ 38 ]. This questioning of time management practices is becoming more common among academics as well [ 41 ]. As some have noted, the issue is not just whether time management works. Rather, the question is whether the techniques championed by time management gurus can be actually counterproductive or even harmful [ 26 , 42 ]. Other scholars have raised concerns that time management may foster an individualistic, quantitative, profit-oriented view of time that perpetuates social inequalities [ 43 , 44 ]. For instance, time management manuals beguile readers with promises of boundless productivity that may not be accessible to women, whose disproportionate share in care work, such as tending to young children, may not fit with typically male-oriented time management advice [ 45 ]. Similarly, bestselling time management books at times offer advice that reinforce global inequities. Some manuals, for instance, recommend delegating trivial tasks to private virtual assistants, who often work out of developing countries for measly wages [ 46 ]. Furthermore, time management manuals often ascribe a financial value to time—the most famous time management adage is that time is money. But recent studies show that thinking of time as money leads to a slew of negative outcomes, including time pressure, stress, impatience, inability to enjoy the moment, unwillingness to help others, and less concern with the environment [ 47 – 51 ]. What’s more, the pressure induced by thinking of time as money may ultimately undermine psychological and physical health [ 52 ].

Concerns over ethics and safety notwithstanding, a more prosaic question researchers have grappled with is whether time management works. Countless general-audience books and training programs have claimed that time management improves people’s lives in many ways, such as boosting performance at work [ 53 – 55 ]. Initial academic forays into addressing this question challenged those claims: time management didn’t seem to improve job performance [ 29 , 30 ]. Studies used a variety of research approaches, running the gamut from lab experiments, field experiments, longitudinal studies, and cross-sectional surveys to experience sampling [ 28 , 56 – 58 ]. Such studies occasionally did find an association between time management and performance, but only in highly motivated workers [ 59 ]; instances establishing a more straightforward link with performance were comparatively rare [ 31 ]. Summarizing these insights, reviews of the literature concluded that the link between time management and job performance is unclear; the link with wellbeing, however, seemed more compelling although not conclusive [ 18 , 32 ].

It is interesting to note that scholars often assess the effectiveness time management by its ability to influence some aspect of performance, wellbeing, or both. In other words, the question of whether time management works comes down to asking whether time management influences performance and wellbeing. The link between time management and performance at work can be traced historically to scientific management [ 60 ]. Nevertheless, even though modern time management can be traced to scientific management in male-dominated work settings, a feminist reading of time management history reveals that our modern idea of time management also descends from female time management thinkers of the same era, such as Lillian Gilbreth, who wrote treatises on efficient household management [ 43 , 61 , 62 ]. As the link between work output and time efficiency became clearer, industrialists went to great lengths to encourage workers to use their time more rationally [ 63 – 65 ]. Over time, people have internalized a duty to be productive and now see time management as a personal responsibility at work [ 43 , 66 , 67 ]. The link between time management and academic performance can be traced to schools’ historical emphasis on punctuality and timeliness. In more recent decades, however, homework expectations have soared [ 68 ] and parents, especially well-educated ones, have been spending more time preparing children for increasingly competitive college admissions [ 69 , 70 ]. In this context, time management is seen as a necessary skill for students to thrive in an increasingly cut-throat academic world. Finally, the link between time management and wellbeing harks back to ancient scholars, who emphasized that organizing one’s time was necessary to a life well-lived [ 71 , 72 ]. More recently, empirical studies in the 1980s examined the effect of time management on depressive symptoms that often plague unemployed people [ 19 , 73 ]. Subsequent studies surmised that the effective use of time might prevent a host of ills, such as work-life conflict and job stress [ 22 , 74 ].

Overall, then, various studies have looked into the effectiveness of time management. Yet, individual studies remain narrow in scope and reviews of the literature offer only a qualitative—and often inconclusive—assessment. To provide a more quantifiable answer to the question of whether time management works, we performed a meta-analysis, the methods of which we outline in what follows.

Literature search and inclusion criteria

We performed a comprehensive search using the keywords “time management” across the EBSCO databases Academic Search Complete , Business Source Complete , Computers & Applied Sciences Complete , Gender Studies Database , MEDLINE , Psychology and Behavioral Sciences Collection , PsycINFO , SocINDEX , and Education Source . The search had no restrictions regarding country and year of publication and included peer-reviewed articles up to 2019. To enhance comprehensiveness, we also ran a forward search on the three main time management measures: the Time Management Behavior Scale [ 21 ], the Time Structure Questionnaire [ 19 ], and the Time Management Questionnaire [ 20 ]. (A forward search tracks all the papers that have cited a particular work. In our case the forward search located all the papers citing the three time management scales available on Web of Science .)

Time management measures typically capture three aspects of time management: structuring, protecting, and adapting time to changing conditions. Structuring refers to how people map their activities to time using a schedule, a planner, or other devices that represent time in a systematic way [ 75 – 77 ]. Protecting refers to how people set boundaries around their time to repel intruders [ 78 , 79 ]. Examples include people saying no to time-consuming requests from colleagues or friends as well as turning off one’s work phone during family dinners. Finally, adapting one’s time to changing conditions means, simply put, to be responsive and flexible with one’s time structure [ 80 , 81 ]. Furthermore, time management measures typically probe behaviors related to these three dimensions (e.g., using a schedule to structure one’s day, making use of downtime), although they sometimes also capture people’s attitudes (e.g., whether people feel in control of their time).

As shown in Fig 1 , the initial search yielded 10,933 hits, excluding duplicates.

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https://doi.org/10.1371/journal.pone.0245066.g001

The search included no terms other than “time management” to afford the broadest possible coverage of time management correlates. Nevertheless, as shown in Table 1 , we focused exclusively on quantitative, empirical studies of time management in non-clinical samples. Successive rounds of screening, first by assessing paper titles and abstracts and then by perusing full-text articles, whittled down the number of eligible studies to 158 (see Fig 1 ).

https://doi.org/10.1371/journal.pone.0245066.t001

Data extraction and coding

We extracted eligible effect sizes from the final pool of studies; effect sizes were mostly based on means and correlations. In our initial data extraction, we coded time management correlates using the exact variable names found in each paper. For instance, “work-life imbalance” was initially coded in those exact terms, rather than “work-life conflict.” Virtually all time management correlates we extracted fell under the category of performance and/or wellbeing. This pattern tallies with previous reviews of the literature [ 18 , 32 ]. A sizable number of variables also fell under the category of individual differences and contextual factors, such as age, personality, and job autonomy. After careful assessment of the extracted variables, we developed a coding scheme using a nested structure shown in Table 2 .

https://doi.org/10.1371/journal.pone.0245066.t002

Aeon and Aguinis suggested that time management influences performance, although the strength of that relationship may depend on how performance is defined [ 18 ]. Specifically, they proposed that time management may have a stronger impact on behaviors conducive to performance (e.g., motivation, proactiveness) compared to assessments of performance (e.g., supervisor rankings). For this reason, we distinguish between results- and behavior-based performance in our coding scheme, both in professional and academic settings. Furthermore, wellbeing indicators can be positive (e.g., life satisfaction) or negative (e.g., anxiety). We expect time management to influence these variables in opposite ways; it would thus make little sense to analyze them jointly. Accordingly, we differentiate between wellbeing (positive) and distress (negative).

In our second round of coding, we used the scheme shown in Table 2 to cluster together kindred variables. For instance, we grouped “work-life imbalance,” “work-life conflict” and “work-family conflict” under an overarching “work-life conflict” category. The authors reviewed each variable code and resolved rare discrepancies to ultimately agree on all coded variables. Note that certain variables, such as self-actualization, covered only one study (i.e., one effect size). While one or two effect sizes is not enough to conduct a meta-analysis, they can nonetheless be grouped with other effect sizes belonging to the same category (e.g., self-actualization and sense of purpose belong the broader category of overall wellbeing). For this reason, we included variables with one or two effect sizes for comprehensiveness.

Meta-analytic procedures

We conducted all meta-analyses following the variables and cluster of variables outlined in Table 2 . We opted to run all analyses with a random effects model. The alternative—a fixed effects model—assumes that all studies share a common true effect size (i.e., linking time management and a given outcome) which they approximate. This assumption is unrealistic because it implies that the factors influencing the effect size are the same in all studies [ 83 ]. In other words, a fixed effects model assumes that the factors affecting time management are similar across all studies—the fallacy underlying this assumption was the main theme of Aeon and Aguinis’s review [ 18 ]. To perform our analyses, we used Comprehensive Meta-Analysis v.3 [ 84 ], a program considered highly reliable and valid in various systematic assessments [ 85 , 86 ].

In many cases, studies reported how variables correlated with an overall time management score. In some cases, however, studies reported only correlations with discrete time management subscales (e.g., short-range planning, attitudes toward time, use of time management tools), leaving out the overall effect. In such cases, we averaged out the effect sizes of the subscales to compute a summary effect [ 83 ]. This was necessary not only because meta-analyses admit only one effect size per study, but also because our focus is on time management as a whole rather than on subscales. Similarly, when we analyzed the link between time management and a high-level cluster of variables (e.g., overall wellbeing rather than specific variables such as life satisfaction), there were studies with more than one relevant outcome (e.g., a study that captured both life satisfaction and job satisfaction). Again, because meta-analyses allow for only one effect size (i.e., variable) per study, we used the mean of different variables to compute an overall effect sizes in studies that featured more than one outcome [ 83 ].

Overall description of the literature

We analyzed 158 studies for a total number of 490 effect sizes. 21 studies explored performance in a professional context, 76 performance in an academic context, 30 investigated wellbeing (positive), and 58 distress. Interestingly, studies did not systematically report individual differences, as evidenced by the fact that only 21 studies reported correlations with age, and only between 10 and 15 studies measured personality (depending on the personality trait). Studies that measured contextual factors were fewer still—between 3 and 7 (depending on the contextual factor). These figures fit with Aeon and Aguinis’s observation that the time management literature often overlooks internal and external factors that can influence the way people manage time [ 18 ].

With one exception, we found no papers fitting our inclusion criteria before the mid-1980s. Publication trends also indicate an uptick in time management studies around the turn of the millennium, with an even higher number around the 2010s. This trend is consistent with the one Shipp and Cole identified, revealing a surge in time-related papers in organizational behavior around the end of the 1980s [ 87 ].

It is also interesting to note that the first modern time management books came out in the early 1970s, including the The Time Trap (1972), by Alec MacKenzie and How to Get Control of your Time and your Life (1973), by Alan Lakein. These books inspired early modern time management research [ 21 , 58 , 88 ]. It is thus very likely that the impetus for modern time management research came from popular practitioner manuals.

To assess potential bias in our sample of studies, we computed different estimates of publication bias (see Table 3 ). Overall, publication bias remains relatively low (see funnel plots in S1). Publication bias occurs when there is a bias against nonsignificant or even negative results because such results are seen as unsurprising and not counterintuitive. In this case, however, the fact that time management is generally expected to lead to positive outcomes offers an incentive to publish nonsignificant or negative results, which would be counterintuitive [ 89 ]. By the same token, the fact that some people feel that time management is ineffective [ 38 ] provides an incentive to publish papers that link time management with positive outcomes. In other words, opposite social expectations surrounding time management might reduce publication bias.

https://doi.org/10.1371/journal.pone.0245066.t003

Finally, we note that the link between time management and virtually all outcomes studied is highly heterogeneous (as measured, for instance, by Cochran’s Q and Higgins & Thompson’s I 2 ; see tables below). This high level of heterogeneity suggests that future research should pay more attention to moderating factors (e.g., individual differences).

Time management and performance in professional settings

Overall, time management has a moderate impact on performance at work, with correlations hovering around r = .25. We distinguish between results-based and behavior-based performance. The former measures performance as an outcome (e.g., performance appraisals by supervisors) whereas the latter measures performance as behavioral contributions (e.g., motivation, job involvement). Time management seems related to both types of performance. Although the effect size for results-based performance is lower than that of behavior-based performance, moderation analysis reveals the difference is not significant (p > .05), challenging Aeon and Aguinis’s conclusions [ 18 ].

Interestingly, the link between time management and performance displays much less heterogeneity (see Q and I 2 statistics in Table 4 ) than the link between time management and other outcomes (see tables below). The studies we summarize in Table 4 include both experimental and non-experimental designs; they also use different time management measures. As such, we can discount, to a certain extent, the effect of methodological diversity. We can perhaps explain the lower heterogeneity by the fact that when people hold a full-time job, they usually are at a relatively stable stage in life. In school, by contrast, a constellation of factors (e.g., financial stability and marital status, to name a few) conspire to affect time management outcomes. Furthermore, work contexts are a typically more closed system than life in general. For this reason, fewer factors stand to disrupt the link between time management and job performance than that between time management and, say, life satisfaction. Corroborating this, note how, in Table 6 below, the link between time management and job satisfaction ( I 2 = 58.70) is much less heterogeneous than the one between time management and life satisfaction ( I 2 = 95.45).

https://doi.org/10.1371/journal.pone.0245066.t004

Moreover, we note that the relationship between time management and job performance (see Fig 2 ) significantly increases over the years ( B = .0106, p < .01, Q model = 8.52(1), Q residual = 15.54(9), I 2 = 42.08, R 2 analog = .75).

https://doi.org/10.1371/journal.pone.0245066.g002

Time management and performance in academic settings

Overall, the effect of time management on performance seems to be slightly higher in academic settings compared to work settings, although the magnitude of the effect remains moderate (see Table 5 ). Here again, we distinguish between results- and behavior-based performance. Time management’s impact on behavior-based performance seems much higher than on results-based performance—a much wider difference than the one we observed in professional settings. This suggests than results-based performance in academic settings depends less on time management than results-based performance in professional settings. This means that time management is more likely to get people a good performance review at work than a strong GPA in school.

https://doi.org/10.1371/journal.pone.0245066.t005

In particular, time management seems to be much more negatively related to procrastination in school than at work. Although we cannot establish causation in all studies, we note that some of them featured experimental designs that established a causal effect of time management on reducing procrastination [ 90 ].

Interestingly, time management was linked to all types of results-based performance except for standardized tests. This is perhaps due to the fact that standardized tests tap more into fluid intelligence, a measure of intelligence independent of acquired knowledge [ 91 ]. GPA and regular exam scores, in contrast, tap more into crystallized intelligence, which depends mostly on accumulated knowledge. Time management can thus assist students in organizing their time to acquire the knowledge necessary to ace a regular exam; for standardized exams that depend less on knowledge and more on intelligence, however, time management may be less helpful. Evidence from other studies bears this out: middle school students’ IQ predicts standardized achievement tests scores better than self-control while self-control predicts report card grades better than IQ [ 92 ]. (For our purposes, we can use self-control as a very rough proxy for time management.) Relatedly, we found no significant relationship between time management and cognitive ability in our meta-analysis (see Table 8 ).

Time management and wellbeing

On the whole, time management has a slightly stronger impact on wellbeing than on performance. This is unexpected, considering how the dominant discourse points to time management as a skill for professional career development. Of course, the dominant discourse also frames time management as necessary for wellbeing and stress reduction, but to a much lesser extent. Our finding that time management has a stronger influence on wellbeing in no way negates the importance of time management as a work skill. Rather, this finding challenges the intuitive notion that time management is more effective for work than for other life domains. As further evidence, notice how in Table 6 the effect of time management on life satisfaction is 72% stronger than that on job satisfaction.

https://doi.org/10.1371/journal.pone.0245066.t006

Time management and distress

Time management seems to allay various forms of distress, although to a lesser extent than it enhances wellbeing. The alleviating effect on psychological distress is particularly strong ( r = -0.358; see Table 7 ).

https://doi.org/10.1371/journal.pone.0245066.t007

That time management has a weaker effect on distress should not be surprising. First, wellbeing and distress are not two poles on opposite ends of a spectrum. Although related, wellbeing and distress are distinct [ 93 ]. Thus, there is no reason to expect time management to have a symmetrical effect on wellbeing and distress. Second, and relatedly, the factors that influence wellbeing and distress are also distinct. Specifically, self-efficacy (i.e., seeing oneself as capable) is a distinct predictor of wellbeing while neuroticism and life events in general are distinct predictors of distress [ 94 ]. It stands to reason that time management can enhance self-efficacy. (Or, alternatively, that people high in self-efficacy would be more likely to engage in time management, although experimental evidence suggests that time management training makes people feel more in control of their time [ 89 ]; it is thus plausible that time management may have a causal effect on self-efficacy. Relatedly, note how time management ability is strongly related to internal locus of control in Table 8 ) In contrast, time management can do considerably less in the way of tackling neuroticism and dampening the emotional impact of tragic life events. In other words, the factors that affect wellbeing may be much more within the purview of time management than the factors that affect distress. For this reason, time management may be less effective in alleviating distress than in improving wellbeing.

https://doi.org/10.1371/journal.pone.0245066.t008

Time management and individual differences

Time management is, overall, less related to individual differences than to other variables.

Age, for instance, hardly correlates with time management (with a relatively high consistency between studies, I 2 = 55.79, see Table 8 above).

Similarly, gender only tenuously correlates with time management, although in the expected direction: women seem to have stronger time management abilities than men. The very weak association with gender ( r = -0.087) is particularly surprising given women’s well-documented superior self-regulation skills [ 95 ]. That being said, women’s time management abilities seem to grow stronger over the years ( N = 37, B = -.0049, p < .05, Q model = 3.89(1), Q residual = 218.42(35), I 2 = 83.98, R 2 analog = .03; also see Fig 3 below). More realistically, this increase may not be due to women’s time management abilities getting stronger per se but, rather, to the fact that women now have more freedom to manage their time [ 96 ].

https://doi.org/10.1371/journal.pone.0245066.g003

Other demographic indicators, such as education and number of children, were nonsignificant. Similarly, the relationships between time management and personal attributes and attitudes were either weak or nonsignificant, save for two notable exceptions. First, the link between time management and internal locus of control (i.e., the extent to which people perceive they’re in control of their lives) is quite substantial. This is not surprising, because time management presupposes that people believe they can change their lives. Alternatively, it may be that time management helps people strengthen their internal locus of control, as experimental evidence suggests [ 89 ]. Second, the link between time management and self-esteem is equally substantial. Here again, one can make the argument either way: people with high self-esteem might be confident enough to manage their time or, conversely, time management may boost self-esteem. The two options are not mutually exclusive: people with internal loci of control and high self-esteem levels can feel even more in control of their lives and better about themselves through time management.

We also note a very weak but statistically significant negative association between time management and multitasking. It has almost become commonsense that multitasking does not lead to performance [ 97 ]. As a result, people with stronger time management skills might deliberately steer clear of this notoriously ineffective strategy.

In addition, time management was mildly related to hours spent studying but not hours spent working. (These variables cover only student samples working part- or full-time and thus do not apply to non-student populations.) This is consistent with time-use studies revealing that teenagers and young adults spend less time working and more time studying [ 98 ]. Students who manage their time likely have well-defined intentions, and trends suggest those intentions will target education over work because, it is hoped, education offers larger payoffs over the long-term [ 99 ].

In terms of contextual factors, time management does not correlate significantly with job autonomy. This is surprising, as we expected autonomy to be a prerequisite for time management (i.e., you can’t manage time if you don’t have the freedom to). Nevertheless, qualitative studies have shown how even in environments that afford little autonomy (e.g., restaurants), workers can carve out pockets of time freedom to momentarily cut loose [ 100 ]. Thus, time management behaviors may flourish even in the most stymying settings. In addition, the fact that time management is associated with less role overload and previous attendance of time management training programs makes sense: time management can mitigate the effect of heavy workloads and time management training, presumably, improves time management skills.

Finally, time management is linked to all personality traits. Moreover, previous reviews of the literature have commented on the link between time management and conscientiousness in particular [ 32 ]. What our study reveals is the substantial magnitude of the effect ( r = 0.451). The relationship is not surprising: conscientiousness entails orderliness and organization, which overlap significantly with time management. That time management correlates so strongly with personality (and so little with other individual differences) lends credence to the dispositional view of time management [ 101 – 103 ]. However, this finding should not be taken to mean that time management is a highly inheritable, fixed ability. Having a “you either have it or you don’t” view of time management is not only counterproductive [ 104 ] but also runs counter to evidence showing that time management training does, in fact, help people manage their time better.

Does time management work? It seems so. Time management has a moderate influence on job performance, academic achievement, and wellbeing. These three outcomes play an important role in people’s lives. Doing a good job at work, getting top grades in school, and nurturing psychological wellbeing contribute to a life well lived. Widespread exhortations to get better at time management are thus not unfounded: the importance of time management is hard to overstate.

Contributions

Beyond answering the question of whether time management works, this study contributes to the literature in three major ways. First, we quantify the impact of time management on several outcomes. We thus not only address the question of whether time management works, but also, and importantly, gauge to what extent time management works. Indeed, our meta-analysis covers 53,957 participants, which allows for a much more precise, quantified assessment of time management effectiveness compared to qualitative reviews.

Second, this meta-analysis systematically assesses relationships between time management and a host of individual differences and contextual factors. This helps us draw a more accurate portrait of potential antecedents of higher (or lower) scores on time management measures.

Third, our findings challenge intuitive ideas concerning what time management is for. Specifically, we found that time management enhances wellbeing—and in particular life satisfaction—to a greater extent than it does various types of performance. This runs against the popular belief that time management primarily helps people perform better and that wellbeing is simply a byproduct of better performance. Of course, it may be that wellbeing gains, even if higher than performance gains, hinge on performance; that is to say, people may need to perform better as a prerequisite to feeling happier. But this argument doesn’t jibe with experiments showing that even in the absence of performance gains, time management interventions do increase wellbeing [ 89 ]. This argument also founders in the face of evidence linking time management with wellbeing among the unemployed [ 105 ], unemployment being an environment where performance plays a negligible role, if any. As such, this meta-analysis lends support to definitions of time management that are not work- or performance-centric.

Future research and limitations

This meta-analysis questions whether time management should be seen chiefly as a performance device. Our questioning is neither novel nor subversive: historically people have managed time for other reasons than efficiency, such as spiritual devotion and philosophical contemplation [ 72 , 106 , 107 ]. It is only with relatively recent events, such as the Industrial Revolution and waves of corporate downsizing, that time management has become synonymous with productivity [ 43 , 65 ]. We hope future research will widen its scope and look more into outcomes other than performance, such as developing a sense of meaning in life [ 108 ]. One of the earliest time management studies, for instance, explored how time management relates to having a sense of purpose [ 73 ]. However, very few studies followed suit since. Time management thus stands to become a richer, more inclusive research area by investigating a wider array of outcomes.

In addition, despite the encouraging findings of this meta-analysis we must refrain from seeing time management as a panacea. Though time management can make people’s lives better, it is not clear how easy it is for people to learn how to manage their time adequately. More importantly, being “good” at time management is often a function of income, education, and various types of privilege [ 42 , 43 , 46 , 109 ]. The hackneyed maxim that “you have as many hours in a day as Beyoncé,” for instance, blames people for their “poor” time management in pointing out that successful people have just as much time but still manage to get ahead. Yet this ill-conceived maxim glosses over the fact that Beyoncé and her ilk do, in a sense, have more hours in a day than average people who can’t afford a nanny, chauffeur, in-house chefs, and a bevy of personal assistants. Future research should thus look into ways to make time management more accessible.

Furthermore, this meta-analysis rests on the assumption that time management training programs do enhance people’s time management skills. Previous reviews have noted the opacity surrounding time management interventions—studies often don’t explain what, exactly, is taught in time management training seminars [ 18 ]. As a result, comparing the effect of different interventions might come down to comparing apples and oranges. (This might partly account for the high heterogeneity between studies.) We hope that our definition of time management will spur future research into crafting more consistent, valid, and generalizable interventions that will allow for more meaningful comparisons.

Finally, most time management studies are cross-sectional. Yet it is very likely that the effect of time management compounds over time. If time management can help students get better grades, for instance, those grades can lead to better jobs down the line [ 110 ]. Crucially, learning a skill takes time, and if time management helps people make the time to learn a skill, then time management stands to dramatically enrich people’s lives. For this reason, longitudinal studies can track different cohorts to see how time management affects people’s lives over time. We expect that developing time management skills early on in life can create a compound effect whereby people acquire a variety of other skills thanks to their ability to make time.

Overall, this study offers the most comprehensive, precise, and fine-grained assessment of time management to date. We address the longstanding debate over whether time management influences job performance in revealing a positive, albeit moderate effect. Interestingly, we found that time management impacts wellbeing—and in particular life satisfaction—to a greater extent than performance. That means time management may be primarily a wellbeing enhancer, rather than a performance booster. Furthermore, individual and external factors played a minor role in time management, although this does not necessarily mean that time management’s effectiveness is universal. Rather, we need more research that focuses on the internal and external variables that affect time management outcomes. We hope this study will tantalize future research and guide practitioners in their attempt to make better use of their time.

Supporting information

S1 checklist. prisma 2009 checklist..

https://doi.org/10.1371/journal.pone.0245066.s001

S1 File. Funnel plots.

https://doi.org/10.1371/journal.pone.0245066.s002

S2 File. Dataset.

https://doi.org/10.1371/journal.pone.0245066.s003

Acknowledgments

We would like to take this opportunity to acknowledge our colleagues for their invaluable help: Mengchan Gao, Talha Aziz, Elizabeth Eley, Robert Nason, Andrew Ryder, Tracy Hecht, and Caroline Aubé.

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The Impact of Time Management on Students' Academic Achievement

S N A M Razali 1 , M S Rusiman 1 , W S Gan 1 and N Arbin 2

Published under licence by IOP Publishing Ltd Journal of Physics: Conference Series , Volume 995 , International Seminar on Mathematics and Physics in Sciences and Technology 2017 (ISMAP 2017) 28–29 October 2017, Hotel Katerina, Malaysia Citation S N A M Razali et al 2018 J. Phys.: Conf. Ser. 995 012042 DOI 10.1088/1742-6596/995/1/012042

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1 Department of Mathematics and Statistic, Faculty of Applied Science and Technology University Tun Hussein Onn Malaysia, Batu Pahat, Johor, Malaysia.

2 Department of Mathematic, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, 35900 Perak, Malaysia.

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Time management is very important and it may actually affect individual's overall performance and achievements. Students nowadays always commented that they do not have enough time to complete all the tasks assigned to them. In addition, a university environment's flexibility and freedom can derail students who have not mastered time management skills. Therefore, the aim of this study is to determine the relationship between the time management and academic achievement of the students. The factor analysis result showed three main factors associated with time management which can be classified as time planning, time attitudes and time wasting. The result also indicated that gender and races of students show no significant differences in time management behaviours. While year of study and faculty of students reveal the significant differences in the time management behaviours. Meanwhile, all the time management behaviours are significantly positively related to academic achievement of students although the relationship is weak. Time planning is the most significant correlated predictor.

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Relation between stress, time management, and academic achievement in preclinical medical education: A systematic review and meta-analysis

Soleiman ahmady.

Department Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Nasrin Khajeali

1 Deprtment of Medical Education, Fasa University of Medical Sciences, Fasa, Iran

Masomeh Kalantarion

Farshad sharifi.

2 Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

Mehdi Yaseri

3 Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of medical Sciences, Tehran, Iran

Identifying the learners' problems is important. Besides, many factors are associated with academic failure, among which time management and stress are more important than any others based on evidence. By using a systematic review and meta-analysis, this study aims to synthesize the findings of studies about the correlation of time management and stress with academic failure to suggest a more in-depth insight into the effect of these two factors on academic failure. Four databases were searched from the inception of January 2018. Publication bias was evaluated visually using funnel plots and sized up by Egger's test. Ninety-four articles were found to be qualified for inclusion after full-text review and additional manual reference made. Of these, 8 were studies of educational interventions that were reviewed in this paper. Regarding the relation of stress and academic performance, the Funnel plot (results not shown) and Egger's test showed no publication bias in the studies ( P = 0.719). Based on this result, the estimated pooled correlation (reverted by hyperbolic tangent transformation) between stress and academic performance was found to be -0.32 (95% confidence interval: -0.38–-0.25). In conclusion, the review recognized a series of potentially mutable medium-to-large correlates of academic achievement, time management, and stress. It would be essential to have experimental data on how easily such self-regulatory capacities can be altered, and these interventions could help students enhance their potential, providing empirical tests for offered process models of academic achievement.

Introduction

Identifying the learners' issues early and offering advice from the start is an essential investment in the training and progress of future practitioners.[ 1 ] The National Committee on Internal Medicine (1999) has described the learner as a trainee who identifies the underlying problems that required to be addressed by a program leader or manager.[ 2 ] Some educators have expressed their concern about difficult learners in case they negatively affect educational programs and other students. Although studies may predict different elements, medical educators would like to be able to predict merely.[ 3 ]

Academic failure is a problem that has turned out to be a central concern for countries in different parts of the world. In order to find the different causes of academic failure, several research projects in this field have been performed. Typically, students experience academic issues with academic and nonacademic characteristics, and the various combinations of reasons for academic failure result in different types of student profiles, suggesting different strategies of intervention.[ 4 ]

The evidence indicates that when intervention techniques are applied for failed students, their performance improves in the subsequent academic year.[ 5 ] Ahmady et al . indicate that failed students can be assisted in becoming successful in the classroom when appropriate intervention techniques are applied. Usually, in research concerning student learning and behavioral outcomes, certain personal attributes of the students are measured, which are then related to some outcome measure. Among these, study skills, such as time management, is one of the factors affecting academic achievement and also stress.[ 6 ]

Personal characteristics are personality, motivation, self-concept, cognitive style, intelligence, and locus of control. Nevertheless, some environmental and contextual difficulties, which lead to unsuccessful learning, are not considered. The purpose of this study is to identify the factors related to the failure of college students.[ 4 ]

Many factors have been related to academic failure.[ 1 ] Ahmady et al . indicate that 21 factors related to academic failure in preclinical medical students, and study skill and stress is reported to be more important among other factors. We have found several studies[ 7 , 8 ] that suggest time management is perhaps more important than any other study strategies.[ 6 ]

West et al . (2011) show that study skills (time management) are usually powerful predictors of first-semester academic performance in medical school and other higher education disciplines.[ 7 ] Practical time management skills are essential. Students who do not plan their time effectively run out of time before running out of the content. Relatively, few studies have investigated the joint contribution of academic performance and study skills.[ 9 , 10 , 11 , 12 ]

Another reason is that medical education is inherently stressful and demanding. An ideal level of stress can increase the level of learning, while over-stress can cause health problems, leading to a decrease in students' self-esteem and failure in their academic competence. A high level of stress can affect the students' learning process in medical school negatively.[ 13 ] Sources of stress include curriculum, personal competence, tolerance, and time outside of medical school. Increased anxiety is associated with increased depression and anxiety.[ 14 , 15 ]

Knowledge about the effective size of these factors (time management and stress) can help policymakers, managers, medical teachers, and counselors track the students' academic failure. It is essential to integrate the evidence produced through all studies to obtain useful information, help medical students, and provide directions for future studies. To the best of the authors' knowledge, this is the first systematic review and meta-analysis of the findings of studies concerning time management and stress associated with academic failure. It suggests a more in-depth insight into the effect of these two factors on the students' academic failure.

Materials and Methods

This systematic review was carried out following PRISMA guidelines.[ 16 ]

Search strategy

PubMed, Web of Knowledge Educational Resources, and Information Center, and Scopus databases were searched.

Using the search No., time limitation was set for searching the resources. For comprehensiveness of the search, the following keywords were used in the abstract, title, and keyword sections: “academic performance” and “academic failure” or “academic achievement” and “drop out;” “medical student” and “struggle student;” “time management” and “stress.” Hand searching was also done in Medical Teacher and Medical Education journals. Furthermore, reference lists of many articles were reviewed to identify the relevant papers. The most celebrated authors in this area were contacted for “gray literature:” conference proceedings, unpublished studies, and internal reports. The obtained data were included in the study. The inclusion criteria for the articles were as follows: being a correlation between study skill and stress with academic performance, observational study design, preclinical medical students, without any language, or time limitation from January 1987 to January 2018.

Inclusion and exclusion criteria

The exclusion criteria for the search were being secondary research or not being a preclinical medical student. All the databases were searched by one reviewer, and Endnote X8 was applied for data management. The articles were imported into Endnote X8 to remove the duplicate data before importing the data into Excel. The imported data were the list of authors, titles, journals, and years of publication. Two team members (N Kh and SA) screened the titles and abstracts to determine the potentially relevant articles. The full-text version of the study was then reviewed if the study met the selection criteria or if there was any doubt concerning the study's eligibility. Furthermore, a third independent researcher was requested to resolve any disagreements.

Quality assessment

The study quality was rated on STROBE guidelines. Over 100 journals have endorsed STROBE guidelines ( http://www.strobe-statement.org ).[ 17 , 18 , 19 , 20 ] Studies were rated for each of the following: title and abstract, introduction, methods, results, discussion, data collection methods, and other information. This yielded a quality rating with a range from 8 to 22.

Data extraction and analysis

As several different variables were tested in each article, thus the article names were repeated. Studies were coded according to author (publication year), effective factors in academic performance, measurement method, type of R, type of analysis, location, and type of study [ Table 1 ]. Two reviewers extracted data from the included articles. They compared extractions and resolved differences through discussion or with a third nonauthors.

Data extraction of articles related to study skill (time management) and stress

SMART=Study management and academic results test

This meta-analysis was conducted via Stata 15.0 software (StataCorp. 2017. Stata Statistical Software: Release 15. College Station, TX: StataCorp LLC). As the distribution of the correlation was highly skewed, the inverse hyperbolic tangent transformation (z = tangh-1(rho) =1/2 ln ((rho + 1)/(rho - 1))) was applied. All the calculations were based on the transformed values. The Cochran's Q test and The I 2 statistic were used to assess and characterize the extent of the heterogeneity, respectively. I 2 -50% was indicated as considerable heterogeneity. Given the high heterogeneity of the data, the random-effects model was used. We used hyperbolic tangent transformation (rho = tangh (z) = [e 2 z - 1]/[e 2 z + 1]) to change the pooled estimates (and its 95% confidence intervals [CI]) to the pooled correlation. All the individual studies results were reported with 95% CIs and demonstrated in a forest plot. Publication bias was evaluated visually using funnel plots and sized up by Egger's test. A P < 0.05 was statistically significant.

The study selection initial database searches retrieved 13,123 articles. After exclusion of duplicate references, conference abstracts, screening titles and abstracts, 6305 articles were selected for further review (title and abstract). A total of 100 articles were found eligible for inclusion after full-text review and additional manual reference screening. Five articles, including the studies of educational interventions, were reviewed in this paper [ Figure 1 ].

Study flowchart demonstrates the inclusion-exclusion process

Study characteristics

Study setting and populations.

Most of the studies were completed in Europe (50%), 2 (25%) USA, and 2 (25%) Asia.

Type of design

The majority design in the articles was prospective, followed by correlational [ Table 1 ].

Aims of studies

The purpose of the studies was to report the effect level of the study skill (time management) and stress on academic performance.

Regarding the relation of stress and academic performance, the Egger' test and Funnel plot (results not shown) indicated that there was no publication bias in the studies ( P = 0.719). The same was obtained when we evaluated the relation of the study skill (time management) and academic performance, not statistically significant ( P = 0.833).

The individual studies transformed between stress and academic performance were shown in a forest plot [ Figure 2 ]; based on this result, pulled correlation (result from hyperbolic tangent transformation) between stress and academic performance was found to be – 0.32 (95% CI [-0.38, -0.25]).

Correlation between stress and academic failure

The individual studies transformed between study skill (time management) and academic performance were demonstrated in a forest plot [ Figure 3 ]; based on this result, pulled correlation (result from hyperbolic tangent transformation) between stress and academic performance was found to be 0.39 (95% CI [0.29, 0.47]).

Correlation between study skill (time management) and academic failure

To the authors' knowledge, this is the first systematic review and meta-analysis of the evidence concerning the effect of study skill (time management) and stress on academic performance.

Overall, with this review, we found medium to high-quality evidence from a modest number of studies, suggesting that study skills (time management) and stress significantly affect academic achievement: study skill (time management) (ES: 0.39) and stress (ES: -0.32).

However, research suggests that study skills (time management) are also significant factors affecting academic achievement in medical schools.[ 8 , 21 , 22 , 23 , 24 , 25 ]

Study skills are one of the more reliable predictors of first-semester total grades.[ 7 ] The predictive strength of first-semester final average is accounted for by scores on time management,

Teaching time management rules, such as preventing postponement, previewing data, reviewing material shortly right after presented, prioritizing items, handling study periods, reviewing repeatedly, and making time for other commitments, is an essential component.[ 26 ]

For instance, sometimes, students procrastinate studying material they have problem with or do not see the applicability of. In this instance, seminars or counseling, which concentrate on arranging these projects for one's optimum time of day such that it will be simpler to focus on the material and reduce procrastination, may be offered.[ 27 ]

Time management aims to improve the nature of activities that require a limited time. The inability to use time in the learning process is the main problem for the students. Previous studies have shown that the excessive intensity of courses affects productivity negatively. In this situation, medical students, who have to cope with an intensive training curriculum, may inevitably but efficiently make the most of their time. To succeed in the education process, medical students must set goals for their education and plan for appropriate academic progress. They, therefore, have to follow course schedules, be prepared for examinations, and use the time available for other activities.[ 28 ]

Another significant issue is that there is a substantial increase in stress levels during study times, in the 1 st year in particular.[ 29 ] Perceived stress is a key factor in discriminating among students with low versus high academic performance.[ 30 ] First-year students face different challenges that can be seen as potential stressors. They have to get familiar with a new environment, get into contact with other students, choose their lectures and seminars, participate in extracurricular activities, and manage their first tests. Another source of students' perceived stress is time-related demands, such as an increasing workload, time pressure, and regulation of their self-study.[ 31 ]

Pfeiffer notes that too much stress is negatively associated with students' readiness, focus, and performance, while positive stress helps the student achieve maximum performance.[ 32 ] It should also be recommended that this situation is the first exam in which students are exposed to a significant amount of integrated curriculum. Often, students are suggested by their seniors to pursue an education in the coming years; thus, they can lower the stress levels, control stress in a better way, and enhance their academic performance.

Managing self-efficacy, flexibility, and social support also are related to academic achievement; thus, intervening to enhance self-efficacy, resilience, and social support may lessen the perception that stress is affecting performance.

Limitations

The limitation of this review is that statistically significant time management and stress have not been reported in all studies.

Conclusions

This review of 31 years of research on the correlation of stress, time management, and academic failure has been devoted to the understanding of the effect of time management and stress on academic achievement of medical students. This systematic review and meta-analysis are the first in the field. We wish that this work provides a base for more focused research and intervention. Finally, our review and others have identified a series of potentially modifiable medium-to-large correlates of academic achievement, time management and stress in particular. It would be worthful to have experimental data on how easily such self-regulatory capacities can be altered, as well as for whom, over what period, and to what extent do such changes to be effective academic performance. These interventions could help students develop their potential and would provide empirical tests for proposed process models of academic achievement.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

Acknowledgments

The authors would like to thank all of authorities and students at Medical School in Shahid Beheshti University of Medical Sciences for their assistance.

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Time Management Is About More Than Life Hacks

• Erich C. Dierdorff

Your productivity hinges on these three skills.

There is certainly no shortage of advice — books and blogs, hacks and apps — all created to boost time management with a bevy of ready-to-apply tools. Yet, the frustrating reality for individuals trying to improve their time management is that tools alone won’t work. You have to develop your time management skills in three key areas: awareness, arrangement, and adaptation. The author offers evidence-based tactics to improve in all three areas.

Project creep, slipping deadlines, and a to-do list that seems to get longer each day — these experiences are all too common in both life and work. With the New Year’s resolution season upon us, many people are boldly trying to fulfill goals to “manage time better,” “be more productive,” and “focus on what matters.” Development goals like these are indeed important to career success. Look no further than large-scale surveys that routinely find time management skills among the most desired workforce skills, but at the same time among the rarest skills to find.

• Erich C. Dierdorff is a professor of management and entrepreneurship at the Richard H. Driehaus College of Business at DePaul University and is currently an associate editor at  Personnel Psychology.

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A Theoretical Research on the Effectiveness of Time Management in Dynamics of Employee-Organization Relationship

• First Online: 06 October 2023

Cite this chapter

• Fatemeh Rezazadeh   ORCID: orcid.org/0000-0002-6208-7944 2 ,
• Sima Rezazadeh   ORCID: orcid.org/0000-0003-1968-7204 3 &
• Mina Rezazadeh 4  

Part of the book series: Contributions to Management Science ((MANAGEMENT SC.))

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Today, the leading concern in managing organizational behavior and human resources is to improve the individuals’ performance working in the organization with the aim of increasing their efficiency. The time dimension of the work has become more critical due to the expansion of global competition and the increased demand for urgent access to products and services. Because in desired time management, determining the goals and priorities, as well as monitoring time used, can provide the effectiveness of occupational processes, maintenance of occupational balance, and success in employee-organization relationships (EOR) by facilitating productivity and reducing stress. This chapter is presented with the aim of theoretical research to identify the effectiveness of time management in EOR dynamics. This research is conducted with a descriptive-analytical method by reviewing literature reviews and library studies. The findings explain and identify the commonalities between time management and EOR, such as manager clarification and foresight in strategic decision-making, manager futurology path, stress management, creativity and innovation, work-family flexibility, job satisfaction, and organizational performance improvement. These commonalities somehow integrate the two areas of employee-organization relationship and time management, and the realization of each can make us experience its synergistic effect in the improvement and dynamics of organizational relationships and the stability of time management.

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Rezazadeh, F., Rezazadeh, S., Rezazadeh, M. (2023). A Theoretical Research on the Effectiveness of Time Management in Dynamics of Employee-Organization Relationship. In: Faghih, N. (eds) Time and Fractals . Contributions to Management Science. Springer, Cham. https://doi.org/10.1007/978-3-031-38188-1_3

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Time Management Strategies for Research Productivity

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Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

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• Nursing Research Medicine & Life Sciences 19%

T1 - Time Management Strategies for Research Productivity

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AU - Cohen, Marlene Z.

AU - Fahrenwald, Nancy

AU - Zerwic, Julie J.

AU - Benefield, Lazelle E.

AU - Anderson, Cindy M.

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N2 - Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

AB - Researchers function in a complex environment and carry multiple role responsibilities. This environment is prone to various distractions that can derail productivity and decrease efficiency. Effective time management allows researchers to maintain focus on their work, contributing to research productivity. Thus, improving time management skills is essential to developing and sustaining a successful program of research. This article presents time management strategies addressing behaviors surrounding time assessment, planning, and monitoring. Herein, the Western Journal of Nursing Research editorial board recommends strategies to enhance time management, including setting realistic goals, prioritizing, and optimizing planning. Involving a team, problem-solving barriers, and early management of potential distractions can facilitate maintaining focus on a research program. Continually evaluating the effectiveness of time management strategies allows researchers to identify areas of improvement and recognize progress.

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KW - efficiency

KW - research productivity

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U2 - 10.1177/0193945912451163

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JO - Western Journal of Nursing Research

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Essential Study Skills

Introduction to time management.

• Getting Things Done
• Creating a Weekly Schedule
• Creating a Semester Plan
• Planning an Assignment
• Creating a Task List
• Putting it all together
• Additional Resources
• Coping With Stress
• Changing Your Perception of Stress
• Problem Solving To Manage Stress
• Reading with Purpose
• Taking Notes in Class
• Deciding What To Study
• Knowing How to Study
• Memorizing and Understanding Concepts
• Taking Tests & Exams
• Creating and Preparing For a Presentation
• Presentation Anxiety
• Delivering Presentations
• Exploring Career Options
• Identifying Areas of Interest
• Knowing Yourself
• Exploring the Labour Market
• Researching College Programs
• Setting Goals
• Tackling Problems
• Bouncing Back
• Sleep Matters
• Sleep Habits
• Sleep Strategies
• Meeting with Your Group
• Agreeing on Expectations
• Dealing With Problems
• Study in Groups

The idea of time management might be new to you. Basically, time management strategies allow you to plan out your time so that you can get things done and have a more balanced, less stressful life. In this module, we’ll explore why you need time management techniques, how to figure out how much time you actually need to accomplish your tasks.

Time Audit: How much time do you need to get everything done in a week?

Time Audit: How much time do you need to get everything done in a week? Accessible Version - Opens in a new window

Your Time Management Needs

• Your Use of Time
• Being Realistic About Your Time

Below are two videos that describe two types of typical college students: a recent high school graduate and a mature student. In additions, you can complete the Time Audit activity to assess your personal time needs.

How to Be Realistic About Your Time

Based on the earlier activity, you now know how many hours you need in a week to meet your personal and school commitments. Watch this video or read the information below for some tips and tools to help you manage your time and bring some balance to your week.

Questions to assess your time needs

Effective time management means creating a balance that allows you to do the things you need to do without getting completely overwhelmed and stressed. This requires being realistic about how much time you need. Try asking yourself these questions:

How much time do I actually have?

There are 24 hours a day, and 168 hours in a week. It sounds like a lot until you consider that you’ll spend some of that time sleeping, eating, getting from place to place, and other things like that. You may be surprised at how much time some little tasks take!

How much time do I need for school work outside of class?

Depending on your program, you should be spending about an average of 1 hour outside of class for every hour you spend in class. For example, 18 hours of class every week means 18 hours every week working on assignments, studying for tests, doing readings, preparing for labs,etc. Added to class time, that’s 36 hours every week - the equivalent of a full time job!

How can I balance my time?

Think about when you will do your outside-of-class work. Consider the following:.

• Spread it out. If you have six hours of class on Tuesday, you don’t necessarily need to go home and study for another six hours. You could plan that study time for a lighter class day, or on the weekend, when you have more time. When you spread out your study time over 7 days of the week, it will likely take you only 2-3 hours per day outside of class time. Working a little every day will be better for establishing a routine, and it will also improve your learning and memory.
• Plan study time for when you are best able to do your work. For example, how effective are you at 1 o'clock in the morning? Not all hours are created equal. One hour of good quality study time is better than three hours when nothing is sinking in. It’s just as much about quality as quantity.
• Consider how your workload might change throughout the semester. Earlier on in the semester, you likely won’t have a lot of big assignments and tests to worry about; however, as the semester goes on, your workload will increase. You’ll likely have several large assignments and tests due all around the same time. Remember that you can think beyond just one week at a time. If you have several busy weeks later in the semester, it can help to get started in an earlier week, when you have more time.
• Your Workload Tipsheet Check out this tipsheet for an illustration of how your workload will change throughout the semester:
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• http://orcid.org/0000-0001-9384-5456 Mohammad Javad Koohsari 1 , 2 , 3 ,
• Andrew T Kaczynski 4 ,
• Akitomo Yasunaga 5 ,
• Tomoya Hanibuchi 6 ,
• Tomoki Nakaya 7 ,
• Gavin R McCormack 8 ,
• Koichiro Oka 2
• 1 School of Advanced Science and Technology , Japan Advanced Institute of Science and Technology , Nomi , Japan
• 2 Faculty of Sport Sciences , Waseda University , Tokorozawa , Japan
• 3 School of Exercise and Nutrition Sciences , Deakin University , Geelong , Victoria , Australia
• 4 Arnold School of Public Health , University of South Carolina , Columbia , South Carolina , USA
• 5 Faculty of Health Sciences , Aomori University of Health and Welfare , Aomori , Japan
• 6 Graduate School of Letters , Kyoto University , Kyoto , Japan
• 7 Graduate School of Environmental Studies , Tohoku University , Sendai , Japan
• 8 Department of Community Health Sciences , University of Calgary , Calgary , Alberta , Canada
• Correspondence to Dr Mohammad Javad Koohsari, Japan Advanced Institute of Science and Technology, Nomi, Japan; koohsari{at}jaist.ac.jp

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• Public health
• Sedentary Behavior
• Health promotion

Introduction

Insufficient physical activity and excessive sitting time among office-based workers have been linked to various health risks and economic consequences. While health promotion interventions are important, the role of workplace design in encouraging active behaviours is increasingly recognised. However, significant gaps exist in knowledge about how workplace design influences these behaviours. This paper identifies the need to investigate the interactive effects of workplace norms and culture and the role of building layouts on workers’ behaviours, as well as the need for more accurate behavioural measures. Bridging these gaps is crucial for designing workplace interventions and promoting active, healthy and productive work environments.

Workplace design: encouraging movement in workplace settings

Existing gaps and future directions, interactive effects of workplace social environments.

Workplace social environments such as norms and culture can significantly influence sedentary behaviours among office-based workers 4 and can affect how workplace design influences workers’ behaviour. Most previous studies have tested the effects of workplace design on employees’ active and sedentary behaviours within Western contexts, 5 leaving a gap in how these relationships vary in other geographical settings with unique workplace norms and cultures. For instance, in a workplace where extended sitting is a cultural norm, employees may still predominantly engage in sedentary behaviour, regardless of having activity-promoting features in their workplace. Conversely, an activity-promoting environment might help mitigate norms towards sitting or even produce multiplicative positive effects in contexts where activity in the workplace is already customary. Conducting studies across varied geographical settings is necessary to identify similarities and differences in the impact of workplace norms and design on workers’ active and sedentary behaviours. Cross-cultural studies can shed light on the generalisability of findings and help develop customised interventions that address specific norms and cultural challenges. Future research can also employ mixed methods to gain a more thorough understanding of the complex interplay between workplace design, norms and culture, and employees’ behaviour. Additionally, the rise of home and hybrid working arrangements indicates that office social norms could extend to home work environments. For example, a culture of regular stretch breaks in the office might encourage similar practices at home, influencing physical activity behaviours remotely. Understanding the detailed relationship between workplace design, norms and employee behaviour is critical for developing targeted contextually relevant interventions that promote active workplace environments.

Precision in tracking workplace behaviours

Accurately measuring employees’ active and sitting behaviours and identifying the ‘locations’ where these behaviours occur is essential to understand their relationships with workplace design attributes. Global positioning systems (GPS) have been commonly used in combination with accelerometer devices to measure and spatially track people’s active and sedentary behaviour in outdoor environments, such as neighbourhoods and cities. 6 Nevertheless, GPS signals have limited accuracy or can be disrupted within indoor environments, resulting in less precise location data.

An indoor positioning system (IPS) can address the limitations of GPS in indoor environments. 7 IPS is a wayfinding technology that uses existing low-cost WiFi and Bluetooth to provide precise locations of individuals inside buildings. The IPS can be integrated with activity-tracking wearable devices, such as accelerometers, pedometers and heart rate monitors, as well as traditional methods like behavioural mapping. This integration allows for the collection of employees’ location data, movement patterns, activity intensities and other biometric data within workplaces. Additionally, the synergy between IPS and wearable devices effectively differentiates between occupational and leisure physical activities in workplaces. This distinction is key to better understanding the health paradox of the different health effects of these two types of physical activities. 8 Furthermore, with the growth of artificial intelligence (AI), there has been a unique opportunity to employ geospatial AI (GeoAI) in workplace environments and health research. GeoAI techniques aim to integrate innovations in spatial sciences with AI, particularly deep learning. 9 The joint application of IPS and GeoAI would enable precise location data of individuals within the workplace while using the power of spatial analysis. GeoAI can analyse workers’ movement patterns derived from IPS in combination with geospatial layers such as spatial layouts, access to common places, and light conditions. For instance, a GeoAI trained by tracking data on people’s movements in various indoor environments would predict people’s movements and derive estimates of the amount of sedentary behaviour of employed people only from planned indoor layout. This analysis allows for identifying hotspots or areas within the workplace where active and sedentary behaviour is prevalent.

Beyond individual design elements: exploring the influence of building layout on workplace behaviour

Most previous studies have primarily examined individual design elements but fail to consider how the overall spatial layout influences movement and behaviour. Building layout encompasses the spatial arrangement of building elements such as walls, doors, windows, and access ways, and plays a fundamental role in defining the functionality of interior spaces. Once a building layout has been established, making substantial alterations to it becomes challenging or, in some cases, impossible. Therefore, designing (and, if feasible, retrofitting) building interiors to promote health is imperative, but it is still unclear which workplace layouts are most supportive of workers’ active behaviours.

The urban design theory of space syntax has the potential to partially address this gap in knowledge. Space syntax uses a set of graph-based estimators to quantify spatial layouts. 10 It offers a framework to investigate the impact of building layout factors, such as workstation arrangement, common area location, and space accessibility, on workers’ movement patterns and behaviours. It goes beyond isolated design elements and considers the spatial configuration as a whole ( figure 1 ). Additionally, more research on ‘how’ people use and perceive their workspaces could complement the space syntax evaluations of building design.

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Space syntax examines building layouts as a whole, using the graph theory: (A)a schematic workplace layout, (B)space syntax axial lines (i.e., longest and fewest lines traversing all spaces) of the layout, and (C)the connectivity of all spaces based on the graph theory.

Conclusions

Future research should investigate the interactive effects of workplace norms and culture on behaviour and conduct cross-cultural studies to identify similarities and differences. Innovative measurement methods can also be employed to accurately measure behaviours and locations where those behaviours occur within workplaces. Additionally, exploring the influence of spatial layout, and using the urban design theory of space syntax, can offer valuable insights into the design of work environments that facilitate workers’ engagement in active behaviours.

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• Sugiyama T ,
• Eakin EE , et al
• Yoshikawa A ,
• Qiu L , et al
• Koohsari MJ ,
• Liao Y , et al
• Waters CN ,
• Chu AHY , et al
• Hadgraft N ,
• Clark BK , et al
• Katapally TR ,
• Pollard B ,
• Engelen L ,
• Held F , et al
• Holtermann A ,
• Hansen JV ,
• Burr H , et al
• Laden F , et al
• Hillier B ,

Contributors MJK conceived the idea and wrote the initial draft of the manuscript. All authors contributed to the writing and assisted with the analysis and interpretation. All authors have read and approved the final manuscript and agree with the order of the presentation of authors.

Funding MJK is supported by the JSPS KAKENHI (grant 23K09701). KO is supported by the JSPS Grants-in-Aid for Scientific Research program (grant 20H04113).

Competing interests None declared. In particular, none of the authors has a financial interest in the Space Syntax Limited company.

Provenance and peer review Not commissioned; externally peer reviewed.

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Engineering professor honored for distinguished scientific research

Civil engineer directs center for smart, sustainable & resilient infrastructure.

In 2019, Munir Nazzal , Ph.D., joined the University of Cincinnati College of Engineering and Applied Science as a professor in the Department of Civil and Architectural Engineering and Construction Management .

At UC, he has received various accolades for his advancements in transportation research, including the UC George Rieveschl Jr. Award for Distinguished Scientific Research for 2024. 

Munir Nazzal, Civil Engineering Professor and Director of the Center for Smart, Sustainable, and Resilient Infrastructure. Photo/Andrew Higley/UC Marketing + Brand

In addition to teaching, Nazzal is director of UC's Center for Smart, Sustainable & Resilient Infrastructure .

He is co-author of more than 160 peer-reviewed publications supported by more than $14 million in research funding. His work focuses on novel methods and technologies to advance sustainable transportation-related infrastructure.

In 2023 the Association of State Highway and Transportation Officials selected his project for the High Value Research Supplemental Award. 

“Dr. Nazzal’s work has a tremendous impact,” said Richard Miller , professor and head of UC's Department of Civil and Architectural Engineering and Construction Management.

“His work on studying infrastructure materials has also resulted in better, higher quality paving materials which is saving money, providing longer service life and improving the infrastructure construction industry. This work has the potential to have a huge impact on the ability of state departments of transportation to manage infrastructure.”

Nazzal and his team focus their research on the use of connected and autonomous (self-driving) vehicles for road assessments, with preparation of infrastructure for next-generation transportation. Recently, Nazzal developed an artificial intelligence system that uses connected and autonomous vehicle sensor data to assess damage in infrastructure assets, such as potholes.

Nazzal is partnering with Honda, the infrastructure engineering firm Parsons Corp., the consulting firm i-Probe and the Ohio Department of Transportation on the first project in the world to use sensors in production-level vehicles to examine assets of transportation infrastructure. The results of this project will have major impacts in the transportation sector, aiming to reduce costs, improve public safety by reducing accidents, and facilitate the safe, widespread deployment of connected and autonomous vehicles. The project improves roads by sensing things like where pavement markers are needed, where intersections need to be refined, and if signs are missing or obscured by the environment. To additionally support his research, Nazzal is also partnered with the Jurgensen Co., a local infrastructure construction firm.

Munir Nazzal with his family after receiving the 2024 George Rieveschl Jr. Award for Distinguished Scientific Research. Photo/Joseph Fuqua II/UC

Alongside his acclaimed research work, Nazzal is a member of Ohio State Transportation Invocation Council and is an editor for ASCE Journal of Materials in Civil Engineering and Buildings Journal. He continues to teach as a professor of civil engineering, and has mentored 35 graduate students.

“Dr. Nazzal’s work is of the highest quality, and it has a tremendous impact beyond Cincinnati,” said UC College of Engineering and Applied Science Dean John Weidner.

• Next Lives Here

The University of Cincinnati is classified as a Research 1 institution by the Carnegie Commission and is ranked in the National Science Foundation's Top-35 public research universities. UC's graduate students and faculty investigate problems and innovate solutions with real-world impact.  Next Lives Here .

Featured image at top: Munir Nazzal presents his transporation research. Photo/Andrew Higley/UC Marketing + Brand

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May 21, 2024

In 2019, Munir Nazzal joined the University of Cincinnati College of Engineering and Applied Science as a professor in the Department of Civil and Architectural Engineering and Construction Management. Throughout his time at UC, he has received various accolades for his advancements in transportation research, including the UC George Rieveschl Jr. Award for Distinguished Scientific Research for 2024.

How can your car make roads safer?

November 20, 2023

The University of Cincinnati will work with Honda Motor Co., infrastructure engineering firm Parsons Corp., consulting firm i-Probe and the Ohio Department of Transportation to demonstrate that new cars can help evaluate roads.

UC students take on net-zero building challenge

October 10, 2022

Students in architecture and engineering programs at the University of Cincinnati are learning about the latest materials and strategies to create more energy-efficient indoor spaces. They will take part in the Solar Decathlon to design the next generation of efficient buildings.

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• Volume 83, Issue 6
• EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update
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• http://orcid.org/0000-0003-0920-888X Tuva Moseng 1 ,
• http://orcid.org/0000-0001-6322-3859 Theodora P M Vliet Vlieland 2 ,
• Simone Battista 3 ,
• David Beckwée 4 ,
• Vladimira Boyadzhieva 5 ,
• http://orcid.org/0000-0002-3478-5665 Philip G Conaghan 6 ,
• Daniela Costa 7 ,
• Michael Doherty 8 ,
• Andrew G Finney 9 , 10 ,
• Tsvetoslav Georgiev 11 ,
• Milena Gobbo 12 ,
• Norelee Kennedy 13 ,
• Ingvild Kjeken 1 ,
• http://orcid.org/0000-0002-8940-0582 Féline P B Kroon 14 , 15 ,
• http://orcid.org/0000-0002-5424-9448 L Stefan Lohmander 16 ,
• Hans Lund 17 ,
• Christian D Mallen 18 ,
• Karel Pavelka 19 ,
• Irene A Pitsillidou 20 ,
• Margaret P Rayman 21 ,
• Anne Therese Tveter 1 ,
• http://orcid.org/0000-0003-4783-8663 Johanna E Vriezekolk 22 ,
• Dieter Wiek 23 ,
• Gustavo Zanoli 24 ,
• http://orcid.org/0000-0001-8602-342X Nina Østerås 1
• 1 Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY) , Diakonhjemmet Hospital , Oslo , Norway
• 2 Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center (LUMC) , Leiden , Netherlands
• 3 University of Genoa Department of Neuroscience Ophthalmological Rehabilitation Genetics and Mother and Child Health , Genova , Italy
• 4 Rehabilitation Research Department , Vrije Universiteit Brussel , Brussel , Belgium
• 5 UMHAT “St. Iv. Rilski” Clinic of Rheumatology, Medical University Sofia , Sofia , Bulgaria
• 6 Leeds Institute of Rheumatic and Musculoskeletal Medicine , University of Leeds and NIHR Leeds Biomechanical Reserch Centre , Leeds , UK
• 7 Comprehensive Health Research Center (CHRC) , Universidade Nova de Lisboa , Lisboa , Portugal
• 8 Department of Academic Rheumatology , University of Nottingham , Nottingham , UK
• 9 Research Institute for Primary Care and Health Sciences , Keele University School of Medicine , Keele , UK
• 10 School of Nursing and Midwifery , Keele University , Keele , UK
• 11 Clinic of Rheumatology, University Hospital St. Marina, First Department of Internal Medicine , Medical University Varna , Varna , Bulgaria
• 12 Positivamente Centro de Psicología , Madrid , Spain
• 13 School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute , University of Limerick , Limerick , Ireland
• 14 Department of Rheumatology , Leiden University Medical Center (LUMC) , Leiden , The Netherlands
• 15 Department of Rheumatology , Zuyderland Medical Centre Heerlen , Heerlen , The Netherlands
• 16 Department of Clinical Sciences Lund, Orthopaedics , Lund University , Lund , Sweden
• 17 Centre for Evidence-Based Practice , Western Norway University of Applied Sciences , Bergen , Norway
• 18 Keele University School of Medicine , Keele , UK
• 19 Institute of Rheumatology, Department of Rheumatology , Charles University First Faculty of Medicine , Praha , Czech Republic
• 20 EULAR Patient Research Partner , Cyprus League Against Rheumatism , Nicosia , Cyprus
• 21 Department of Nutritional Sciences , University of Surrey Faculty of Health and Medical Sciences , Guildford , UK
• 22 Research & Innovation , Sint Maartenskliniek , Nijmegen , The Netherlands
• 23 EULAR Patient Research Partner , Deutsche Rheuma-Liga , Bonn , Germany
• 24 Orthopaedic Ward , Casa di Cura Santa Maria Maddalena , Novara , Italy
• Correspondence to Dr Tuva Moseng, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; tuva.moseng{at}diakonsyk.no

Introduction Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed.

Methods The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed.

Results The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0–10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work.

Conclusions The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.

• Osteoarthritis, Knee
• Osteoarthritis
• Rehabilitation
• Physical Therapy Modalities
• Therapeutics

This is an open access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0). See: http://creativecommons.org/licenses/by-nc/4.0/ .

https://doi.org/10.1136/ard-2023-225041

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Introduction

Osteoarthritis (OA) is the most common joint disease worldwide, 1 with an increasing global burden of disability and healthcare utilisation. 2 The number of people with OA globally rose by 28% from 2010 to 2019, affecting over 500 million people, and about 6%, worldwide. 3 Due to an ageing population, increasing obesity and sport-related joint injuries, the disease will become even more prevalent in the forthcoming years. 2 In 2019, OA was the 15th highest-ranked cause of years lived with disability (YLDs) worldwide and was responsible for 2% of the total global YLDs. 3 OA is regarded as a severe disease, and serious condition and people with OA commonly experience pain, stiffness and associated functional loss. 4 Optimal management of hip and knee OA has important implications for the individual and society through the potential for improving individual health, work participation and utilisation of healthcare services. However, most people with OA do not receive optimal management. 5 6 In order to reduce the evidence-to-practice gap and the future burden 7 of this disease, the healthcare services’, policy-makers’ and the population awareness of the importance and benefits of evidence-based management of OA must be improved.

EULAR recommendations, including priorities for implementation and future research, can play a role in increasing awareness and uptake of best evidence care. In 2013, an EULAR Task Force (TF) developed recommendations for the non-pharmacological core management of hip and knee OA. 8 Since then there remains no cure in sight for OA, and effective disease-modifying drugs are lacking. 2 Therefore, non-pharmacological approaches are still considered a core treatment for people with hip and knee OA, aiming to alleviate symptoms and improve or maintain physical function. Since the publication of the 2013 recommendations, a large number of studies on the effectiveness of core non-pharmacological treatment modalities and new methods for delivery and follow-up of such treatments have been published. An update of these recommendations would potentially have implications for the level of evidence (LoE) categories and could lead to revisions of the recommendations and formulation of new recommendations with important implications for OA management.

The main aim of this TF process was to update the 2013 evidence-based recommendations for non-pharmacological core management, provide additional details on effectiveness, safety and cost-effectiveness, and formulate research and educational agendas and priorities for implementation activities. The target groups for the updated recommendations are people with hip or knee OA, all healthcare providers involved in the delivery of non-pharmacological interventions in OA care, researchers in the field of OA, officials in healthcare governance and reimbursement agencies and policy-makers.

The Standardised Operating Procedures for EULAR-endorsed Recommendations 9 were used as a framework for this project. The structure of the manuscript is guided by the Appraisal of Guidelines, Research and Evaluation instrument. 10

To pursue the task of updating the 2013 recommendations, a multidisciplinary TF with in-depth knowledge of non-pharmacological OA care was established. The TF consisted of 25 members from 14 European countries and included 9 physiotherapists, 6 rheumatologists, 2 orthopaedic surgeons, 2 psychologists, 2 patient research partners, 1 occupational therapist, 1 nurse, 1 general practitioner and 1 nutrition expert. A steering group, including a convenor (NØ), a methodologist (TPMVV) and a research fellow (TM), managed the process.

During the first digital TF meeting, the rationale for the update of the recommendations was presented, and the definition of core non-pharmacological management was clarified. The TF agreed on 11 research questions based on the research propositions from the 2013 recommendation. For the subsequent systematic literature review (SLR), the research questions were organised according to the population, intervention, control and outcome (PICO) format with associated search terms ( online supplemental file 1 ). The new search terms added to the previous search strategy were related to the following topics: remote care, shared decision-making, psychological interventions/cognitive behaviour therapy (CBT)-based interventions and specific exercise modalities (eg, strength training and aerobic exercise). Due to the expected large body of published literature since the previous literature review from 2012, combined with the available resources and strict timeline for this update, it was decided that this SLR should primarily focus on evidence from systematic reviews (SRs) and meta-analyses of randomised controlled trials (RCTs) and secondarily on evidence from single RCTs. As this SLR was an update of a previously unpublished SLR, along with its pragmatic approach, it was decided that the details were best presented as online supplemental file 1 rather than a publication of its own.

Supplemental material

The SLR was conducted by the fellow and convenor in close collaboration with an experienced librarian (HIF) and with support from the methodologist. Three main literature searches were conducted in the databases Medline (Ovid), Embase (Ovid), AMED (Ovid), Cochrane Library (Cochrane TRIALS), CINAHL (Ebsco) and Epistemonikos (SR search only).

The primary literature search aimed at identifying relevant SRs of RCTs investigating the effectiveness of core non-pharmacological management strategies as specified in the PICOs. The search was conducted from 2012 (the end year of the previous search) until 17 February 2022 and later updated until 27 May 2022 ( online supplemental file 1 ). Based on the PICOs, two authors (TM and NØ) independently screened titles and abstracts. Potentially relevant studies were read and evaluated in full text. Studies were included if they were SRs, including a meta-analysis of two or more RCTs on people diagnosed with hip or knee OA or with persisting knee pain in people 45 years or older and investigating non-pharmacological core management strategies. Relevant comparisons were no intervention, usual care or any other intervention. Relevant outcomes were pain, physical function, quality of life (QoL), patient global assessment of target joint, adverse effects or cost-effectiveness. The included studies were categorised under the 11 research questions. If relevant, one study could inform multiple research questions. The quality of the included SRs was evaluated with A MeaSurement Tool to Assess systematic Reviews (AMSTAR II). 11 The assessments were conducted independently by three assessors (GS, EAB and IS), working in pairs independent of the TF, with experience in quality assessment of SRs and RCTs. Disagreements between the assessors were resolved through discussion.

A second literature search with a comparable search strategy was conducted to identify newer RCTs not included in the latest published SR on the same topic, or relevant RCTs not included in any SRs, or RCTs on research questions for which no relevant SRs were identified. To identify such RCTs published in the past four to 5 years, the search was conducted from 1 January 2018 to 27 May 2022.

A third literature search was conducted with a similar search strategy from 1 January 2012 to 31 December 2017, aiming to identify relevant RCTs specifically on the research questions for which no relevant SRs had been identified. The two last searches were screened independently by the same two authors, and relevant studies were read and evaluated in full text. Studies were included if they were RCTs relevant to the PICOs. The quality of the included RCTs was assessed with the Cochrane Risk of Bias tool 2 (RoB2) 12 independently by two researchers (EAB and IS) independent of the TF. Disagreements between the assessors were resolved through discussion.

In the period before the second TF meeting, five digital subgroup meetings were arranged. Groups of 4–5 TF members and the steering group participated in each meeting. The purpose of the subgroup meetings was to go through the relevant results from the SLR and to discuss and prepare preliminary suggestions for revisions and updates of the recommendations to guide the discussion at the second TF meeting. The group discussed between 1 and 3 of the previous 11 recommendations in each subgroup meeting. This method was implemented to allow all TF members to express their opinions in smaller forums and potentially to reduce the workload of the second TF meeting.

During the second digital TF meeting, the results from the SLR, along with the proposed updates from the subgroups, were presented to the whole TF. The previous recommendations and the proposed updates were then discussed in light of the SLR and the expertise of the group. After the discussions and revisions, the TF members voted for consensus on each revised overarching principle and recommendation (defined as 75% or more in favour of the suggested updates). After the meeting, the updated list of recommendations was collated and emailed to the TF members in a digital survey to rate the level of agreement (LoA) on a 0–10 point scale (0=totally disagree, 10=totally agree). Further, the TF voted on the prioritised order of the recommendations for implementation activities. The TF also formulated a research agenda based on identified gaps in the evidence. The steering group defined the LoE and strength of each recommendation in accordance with the Oxford Levels of Evidence. 13 The steering group also formulated the educational agenda on behalf of the TF.

The three systematic literature searches yielded a total of 6816 references after the removal of duplicates ( figure 1 ). From these, 67 SRs and 31 RCTs were initially considered relevant for the SLR. However, we chose to extract data from 36 of the SRs due to reasons elaborated in online supplemental file 1, p.49 ,. The most frequent reason was that the interventions under study were not considered relevant for this review. The quality of the included SRs was generally poor, with 35 of 36 studies being rated with an overall low or critically low quality by the AMSTAR II tool ( online supplemental file 1 ). The critical items that most often contributed to the overall low quality of the studies were: the lack of an explicit statement that the review methods were established prior to the conduct of the review; the lack of the use of a comprehensive literature search strategy; and lack of a list of excluded studies with reasons for exclusion. There was large variation in the overall quality of the included RCTs as assessed by the RoB2 tool ( online supplemental file 1 ). Most studies with a low risk of bias were on exercise interventions and delivery, whereas there were higher concerns related to the studies on, for example, lifestyle-related interventions. Most commonly, these concerns were related to the elements of measurement of the outcome (eg, the lack of a blinded outcome assessor).

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PRISMA flow diagram. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

The main updates to the recommendations are summarised in box 1 . The TF agreed to rephrase and change two previous recommendations into overarching principles. These were the recommendations on: (1) the use of a biopsychosocial approach in the initial assessment and (2) the recommendation on individualisation of treatment. It was decided that these were generic statements used to inform the basis for management rather than specific treatment recommendations. Inherent to the nature of these statements, relevant studies were absent from the SLR. 14

What is new?

The updated recommendations have been reorganised into two overarching principles and eight treatment recommendations.

The wording of each recommendation is condensed.

The level of agreement is above 9 for all recommendations.

The level of evidence is 1a/1b for seven of the eight recommendations.

It was further decided to revise the nine previous recommendations into eight updated recommendations by merging the recommendations on footwear and walking aids, other assistive devices and adaptations. Moreover, to improve readability the previous recommendations were shortened, and subsections were rewritten and moved to the explanatory text. In addition, the TF also discussed the order for the presentation of the recommendations and decided to change this into a more logical sequence.

High LoAs were achieved for all eight recommendations, and seven recommendations were graded with LoE 1a/1b and strength level A. Recommendation 2—on delivery of information, patient education and self-management—was ranked by the TF as having the highest priority for implementation. Table 1 summarises the updated overarching principles, recommendations, LoA, LoE, strength of recommendation and priority for implementation.

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Overarching principles and specific recommendations for the non-pharmacological core management of hip and knee osteoarthritis

Recommendation 1

People with hip or knee OA should be offered an individualised, multicomponent management plan that includes the recommended core non-pharmacological approaches.

This recommendation deals with the provision of an integrated package of care rather than single treatments alone or in succession. The majority of new, relevant SRs and RCTs informing this recommendation investigated the effectiveness of the combination of patient education and exercise or the combination of patient education, exercise and diet or the combination of behaviour change techniques/pain-coping skills training and exercise, compared with information or one of the treatments alone. 15–18 The updated evidence shows that combining treatments leads to larger effects on pain and function compared with providing the treatments separately, thereby providing a rationale for combining different treatment modalities. The combination of education, exercise and dietary weight management was also considered cost-effective compared with physician-delivered usual care investigated in five healthcare systems. 19 The TF discussed that, although not all potential combinations of treatments are investigated in meta-analyses or newer RCTs, the results of available studies are likely to be generalisable to different combinations. Thus, the TF agreed on the general consideration of multicomponent treatments from a broader spectrum of potential combinations based on an assessment of a patient’s individual needs and preferences.

Through the SLR, no specific evidence was retrieved with regard to the effects of pacing and maintenance of activity. This specific element was therefore removed from the recommendation.

Recommendation 2

People with hip or knee OA should be offered information, education and advice on self-management strategies (considering available modes of delivery) and these should be included and reinforced at subsequent clinical encounters.

Recommendation 2 concerns the delivery of information, education and advice on self-management strategies. New evidence from the SLR showed zero to small significant effects on pain and function from patient education as a single intervention in the short term, which is in line with the previous recommendation. 15 20 In 2013, this recommendation focused on how education and information should be delivered in terms of being individualised, being included in every aspect of management, and specifically addressing the nature, causes, consequences and prognosis of OA. Moreover, it was stated that this should be reinforced and developed, supported by written or other types of material, including partners or carers of the individual, if relevant. The current TF acknowledged the importance of these aspects to ensure the effective delivery of information and education for people with hip and knee OA. However, none of the studies from the SLR could provide specific evidence for any of these aspects, except with regard to delivery method. One SR reported the effects of patient education delivered through telephone when compared with usual care, but the results were not significant for pain or disability. 20 The TF further chose to add self-management to the updated recommendation. Evidence from two SRs, including seven RCTs, compared structured self-management programmes against a large range of control interventions. Zero to small favourable effects were found for self-management, delivered face to face or digitally, compared with routine/usual care. 21 22 Despite the limited effects reported in the literature, the TF agreed that self-management is a concept closely related both to the delivery of information and education in a clinical setting and to the uptake of other relevant treatment modalities.

Recommendation 3

All people with hip or knee OA should be offered an exercise programme (eg, strength, aerobic, flexibility or neuromotor) of adequate dosage with progression tailored to their physical function, preferences and available services.

The body of literature investigating the effects of different types of exercise regimes was already large when the 2013 recommendations were published. Aiming to progress the knowledge on the effects of exercise for hip and knee OA, the current SLR did not focus on studies investigating the effects of general exercise on hip and knee OA as these effects were well established previously. 23 24 The aim was rather to identify studies investigating the effects of well-defined exercise modalities, as well as studies looking more specifically into exercise dosage.

For hip OA, one SR summarised the effects of supervised, progressive resistance training, which reported beneficial effects on pain, function and QoL. The effect sizes, however, were small with large CIs. 25

For knee OA, four SRs and five additional RCTs were identified on the exercise 26–28 modalities Tai Chi, yoga, stationary cycling, proprioceptive training, weight-bearing and non-weight bearing exercise, and neuromuscular exercise combined with strength training. 29–33 Overall, the results showed small to moderate positive effects on pain and function for all these exercise modalities compared with no-exercise control (no intervention, waiting list or non-exercise interventions). Still, the results were less clear in head-to-head comparisons of different exercise types, modalities or doses.

In summary, results showed that a variety of exercise modalities might lead to improved pain and function for people with hip or knee OA, making it difficult to recommend one type of exercise over another. The optimal exercise dosage is also difficult to establish, with evidence from 1 SR on hip OA (including 12 RCTs) and 1 SR on knee OA (including 45 RCTs) providing some evidence that exercise in line with dose recommendations from the American College of Sports Medicine provided larger improvements in pain compared with non-compliant exercise programmes. 34–36 The differences, however, were small, and the clinical relevance is debatable. Two newer RCTs on knee OA, comparing high-intensity to low-intensity resistance training or no-exercise control, found no or only small between-group differences with regard to pain and function, 37 38 thus making it difficult to make explicit recommendations on exercise dosage.

With respect to safety, adverse events in exercise studies for hip and knee OA were investigated in two SRs. 39 40 The two studies concluded that, although the report of adverse events in exercise studies was inconsistent and some patient drop-outs were potentially misclassified, adverse events were generally uncommon and non-serious, and that exercise seemed to be associated with minimal risk of harm. Concerning the economic aspects of exercise, one SR on cost-effectiveness found that in the majority of the 12 included studies, exercise for hip and knee OA showed cost-effectiveness at conventional willingness-to-pay thresholds. 19

The TF chose to update this recommendation, highlighting that the choice of exercise should be based on individual function, patient preferences and available services. 41 Overall, exercise is by far the most studied and strongly recognised non-pharmacological core management treatment option and this recommendation has the strongest evidence base. The TF also expressed the importance of maintaining exercise over time for the positive effects to persist.

Recommendation 4

The mode of delivery of exercises (eg, individual or group sessions, supervised or unsupervised, face to face or by using digital technology, land-based or aquatic exercise) should be selected according to local availability and patient preferences. The exercises preferably should be embedded in an individual plan for physical activity.

As established in the description of recommendation 3, there is convincing evidence for the effectiveness of various exercise modalities on pain and function in hip and knee OA. However, the delivery method of exercise programmes varies largely across studies and may influence study outcomes.

One SR found superior effects from technology-supported exercise compared with control with non-technological or no care services on pain, function and QoL, 42 whereas another SR found superior effects from telehealth-based exercise compared with no-telehealth exercise control for pain but not for function or QoL. 43 The reported effect sizes were small. One additional RCT found a small, significant effect on function at 6 months follow-up for an education combined with strengthening exercise follow-up through telephone calls compared with education alone, but no other between-group differences in pain and function were detected after 6 and 12 months. 44 Another RCT comparing access to an educational website combined with exercise supported by automated behaviour change text messages to access to the educational website alone found significant superior effects of the combined first intervention on pain and function after 24 weeks. 45 For aquatic exercise, one SR reported small short-term beneficial effects for pain and function compared with no intervention or usual care. However, another SR comparing aquatic exercise to land-based exercise did not find any of these modes superior to the other. 46 47 One RCT of a three-stage stepped care exercise programme compared with educational materials found beneficial, although not clinically relevant, effects of the stepped care programme on pain and function at 3 and 9 months, but not at 6 months. 48 Analyses of the cost-effectiveness of the same stepped-care intervention concluded that there is a high probability of short-term cost-effectiveness. 49

The new evidence adds information on technology-supported delivery of exercise, aquatic exercise and a stepped care strategy for exercise delivery. The results from these studies show a wide variety of potentially effective delivery methods for exercise, which in clinical practice should be aligned with patient preferences and the availability of local services. The TF also underlined the importance of the exercise programme being embedded in an individual plan for physical activity. Such plans should be set up in accordance with well-recognised recommendations for physical activity, such as from the WHO or EULAR. 41 50 General physical activity has multiple health benefits and is also important for the management of common comorbidities associated with OA, such as cardiovascular disease and diabetes. 51 52

Recommendation 5

People with hip or knee OA should be offered education on the importance of maintaining a healthy weight. Those overweight or obese should be offered support to achieve and maintain weight loss.

In the updated SLR, three SRs were identified, including one network meta-analysis investigating the effects of weight loss interventions. Two were on studies of knee OA, 19 53 whereas the third included studies of both hip and knee OA, although only 2 of the 19 trials included in that study were conducted on a mixed hip and knee OA population. 54 The results from this SR showed beneficial effects, compared with minimal care, of both diet and multifocused weight-loss interventions (combining diets, telephone coaching, psychological pain-coping interventions/CBT, specialist referral education and exercise) on pain and disability, with the largest effect size on pain for multifocused interventions. Further, it was reported that when comparing weight-loss-focused interventions (diets) to exercise, no between-group differences were detected for pain or disability. When comparing combined interventions of dietary weight loss and exercise to dietary weight loss or exercise alone, small effects were found in favour of the combined intervention.

In the network meta-analysis, bariatric surgery was the most effective pain-reducing intervention, followed by a low-calorie diet combined with exercise intervention. 53 The last SR on knee OA used cost-effectiveness as an outcome and reported that an intensive 18-month diet and exercise intervention with the goal of 5% weigth loss was likely to be an efficient use of healthcare resources compared with a healthy lifestyle control. 19

The above-mentioned studies made it clear that there is increasing evidence supporting multifocused weight loss interventions as beneficial for OA pain and disability. Therefore, the TF recommended that people with overweight or obesity and OA should be offered support to achieve and maintain weight loss. The TF notes that the amount of evidence mainly stems from studies on knee OA. As overweight and obesity are strong risk factors for the development and progression of OA, and in particular knee OA, 2 the TF also wanted to add to the recommendation the importance of education on the benefits of maintaining a healthy weight.

Recommendation 6

For people with hip or knee OA, consider walking aids, appropriate footwear, assistive devices and adaptations at home and at work to reduce pain and increase participation.

Through the SLR, four SRs investigating the effects on knee OA of lateral wedge insoles compared with other types of insoles, including flat/neutral insoles or knee braces, were retrieved. These studies did not report any between-group differences for any comparisons on pain or function. 55–58 On the other hand, one RCT reported a small between-group difference in favour of lateral wedge insoles compared with neutral insoles on a single pain scale in people prescreened to knee adduction moment improvements (but not on other pain scales, function or QoL). 59 For footwear, one RCT found positive effects of biomechanical footwear with individually adjustable external convex pods attached to the outsole compared with control footwear. 60 Another RCT found small effects after 6 months on pain, but not on function, from wearing stable, supportive shoes over flat flexible shoes for at least 6 hours per day. 61

Summarised, most evidence did not support the use of any lateral wedged or other insoles to affect pain or function in knee OA. The results from one RCT provided some support for the use of stable, supportive shoes. The TF wanted to add that from a clinical perspective, the use of comfortable shoes, big enough to give ample space for the toes when weight-bearing, is still a general recommendation for people with hip and knee OA.

For other types of assistive aids and devices, two RCTs comparing the use of canes to the non-use of auxiliary gait devices were identified. The results were contradictory, and conclusions on the effect of cane were difficult to draw from the available evidence. 62 63 No studies were retrieved for other types of assistive devices or home adaptations. Based on the expert knowledge of the group, it was argued that such devices could still be useful to some people with hip or knee OA in terms of reducing pain, undertaking daily activities and improving participation. The TF wanted to emphasise that improving participation is an important aspect underpinning this specific recommendation. Assistive devices may serve as means to reduce pain and improve participation both at home and at work and should, therefore, be considered in that context. Examples of such devices might be devices to aid dressing, height-adjustable chairs, raised toilet seats, handrails in staircases or the use of appropriate walking aids.

Recommendation 7

People with hip or knee OA with or at risk of work disability should be offered timely advice on modifiable work-related factors and, where appropriate, referral for expert advice.

OA is one of the leading causes of reduced work participation, and the disease may critically affect the number of sick days and, ultimately, the extension of a person’s work career. 64 Although there are well-known occupational risk factors, such as heavy lifting and knee straining activities associated with the development of knee OA, 65 it was noted that there is a lack of studies on vocational rehabilitation for people with hip or knee OA. In the current update, only one relevant RCT was retrieved. This study used workability as an outcome, whereas the study intervention in both groups focused on self-management with the addition of an activity tracker in the intervention group. In this study, no between-group differences were reported for workability. 66

Although little research has been conducted, the TF considered that appropriate interventions to increase work participation for people with hip and knee OA are highly relevant. A proper assessment of the individual work situation may have a large impact and should receive attention during consultations. 67 Health professionals, in cooperation with the employer, should be able to offer timely advice on modifiable work-related factors such as working from home, the use of height-adjustable desks and office chairs, the possibility of changing work tasks, commuting to/from work, use of assistive technology, and receiving support from management, colleagues and family towards employment. The TF also noted that adaptations to improve workability might be considered and applied not only at the workplace but also in the home.

Recommendation 8

Consider employing elements of behaviour change techniques when lifestyle modifications are needed (eg, physical activity, weight loss) for people with hip or knee OA.

This recommendation concerns the potential need for lifestyle change in people with hip and knee OA. It focuses specifically on physical activity and weight loss as part of a healthy lifestyle since these aspects are specifically relevant for people with hip or knee OA. One SR and eight additional RCTs were identified on various interventions to enhance a healthy lifestyle, mainly through maintaining physical activity over time. The SR reported small to moderate effects of adding booster sessions to exercise programmes to improve mid-term to long-term adherence to exercise. 68 Furthermore, one RCT reported statistically significant improvements in pain and function from a combined programme of pain coping skills training and lifestyle behavioural weight management lasting 24 weeks compared with these interventions alone or standard care. 69 Interventions from the other RCTs aiming to support people with OA to improve their lifestyle and sustain such changes over time, included interventions of behaviour-graded activity, improving exercise adherence with telephone counselling, an app to enhance a healthy lifestyle, physical activity with telephone follow-up and a self-management lifestyle intervention. 70–72 However, when the effects on pain and function of these interventions were compared with standard care or other minimal interventions, none to very small between-group differences were observed for the comparisons. The TF wanted to enhance the importance of long-term follow-up on health behaviour change and not just recommend lifestyle change as a single intervention. The TF also discussed that the EULAR recommendation on core competencies for health professionals in rheumatology underlines that health professionals should be able to provide the principles of behaviour change techniques in the management of people with rheumatic and musculoskeletal disorders. 73

Research and educational agendas

The proposed research agenda ( table 2 ) was based on gaps identified in the literature and on topics which emerged during discussions among the TF members.

Research agenda for the non-pharmacological core management of people with hip and knee osteoarthritis

The education agenda ( table 3 ) highlights activities relevant to promote appropriate management of people with hip and knee OA.

Educational agenda for the non-pharmacological core management of people with hip and knee OA

Through this update, the recommendations for the non-pharmacological core management of hip and knee OA have been revised into two overarching principles and eight treatment recommendations. The revisions are based on research evidence, expert discussions and consensus. Since the publication of the 2013 recommendations, a number of new studies have been published on non-pharmacological treatment modalities and their methods of delivery. The updates to the recommendations are thus well anchored in evidence from research and the perspectives of the TF members, representing different professional, cultural and personal backgrounds, including the perspective of people with OA. The process led to a broad consensus within the TF on the updated principles and recommendations, reflected by the high LoA for all the revised recommendations. Such strong consensus gives reason to believe that the recommendations are suitable for use and implementation across European healthcare systems. These recommendations are also in line with recently published treatment recommendations for hip and knee OA by other societies. 74–76

The number of relevant SRs and RCTs retrieved through the SLR was high, especially for the research questions concerning exercise and delivery of exercise, with data drawn from a total of 15 SRs and 11 additional RCTs. The number of new studies led to an upgrade of the LoE for most of the recommendations, and seven of eight recommendations are now supported by level 1a or 1b evidence. However, it should be noted that the stated LoE does not necessarily involve all aspects of every recommendation and does not distinguish between hip and knee OA. The number of studies on hip OA was markedly lower than those on knee OA for all the treatment modalities. Therefore, the recommendations are generally weaker for hip OA than knee OA. There is an increasing recognition of differences between hip and knee OA, which heightens the need for more hip OA-specific studies to improve outcomes for this group specifically. 77 This is also highlighted in the proposed research agenda ( table 2 ). Further, as the aim was to address relevant non-pharmacological core management strategies, the recommendations do not specifically advise the management of subgroups of the OA population, for instance, younger adults or adults with a high burden of comorbidities. The authors are also aware of a number of ongoing studies addressing a range of innovative digital programmes in OA care. Such approaches will likely receive further attention in future updates of these recommendations. 78–81

With regard to outcomes, most of the included studies reported effects primarily on pain and physical function. To follow the recommendations on prioritised outcomes in OA research, 82 more studies investigating the effects of interventions on QoL and patients’ global assessment of the target joint may have provided additional relevant information. Workability and cost-effectiveness are two other outcomes of increasing interest when investigating the effect of interventions from a broader perspective. This SLR identified some studies including these outcomes, thus adding new and important knowledge to the recommendations. Nevertheless, additional studies with a focus on interventions to prevent the decline in workability and studies examining cost-effectiveness are still needed as such knowledge is important for healthcare governance and policy-makers when planning and prioritising effective OA care. Another relevant aspect of this update is the inclusion of studies investigating potential harm or adverse events from the interventions under study. Only two SRs specifically looking into this subject were identified. Still, the results add new knowledge to this important, although understudied, aspect of non-pharmacological interventions. 83

The challenges of implementing recommended care for people with hip and knee OA are well documented. 84 It is also apparent that developing recommendations is not sufficient on its own to influence practice. 85 Therefore, efforts have been made to address the impact and to develop strategies for the implementation of treatment recommendations. For future implementation, collaboration with other organisations focusing on OA care, such as The Osteoarthritis Research Society International, must be considered. EULAR highlights that implementing all recommendations at once is probably not feasible in practice. 86 The TF voted that the recommendation on information, education and self-management was ranked as the recommendation with the highest priority for implementation. This recommendation may play an important role as a basis for all other management and may improve people’s ability to live a good life with OA, as well as being an enabler of, aspects such as physical activity. 87 The prioritisation of the recommendations for implementation activities is also important with respect to the effective utilisation of healthcare services. As the OA population is growing, the need for effective healthcare utilisation and sustainable management strategies to improve outcomes will be vital to minimising the burden of OA at an individual and a societal level. 88

To conclude, the TF reached a broad consensus on the updated recommendation for non-pharmacological core OA management as well as on a research agenda highlighting the current evidence gaps, on an educational agenda and on the priority of the recommendations to support implementation activities.

Ethics statements

Patient consent for publication.

Not applicable.

Acknowledgments

We thank the librarian Hilde Iren Flaatten, University of Oslo, Norway, for supporting the literature searches and Emilie Andrea Bakke, Ingrid Skaalvik and Geir Smedslund, Diakonhjemmet Hospital, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology, Oslo, Norway, for their thorough work in the AMSTAR II and Cochrane risk of bias assessments of the included studies.

PGC is funded in part by the National Institute for Health and Care Research (NIHR) through the Leeds Biomedical Research Centre.

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Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1

Handling editor Josef S Smolen

X @DrS_Battista

Contributors TM was the research fellow for the project, undertaking the SLR in cooperation with NØ. The fellow was supervised by the steering group consisting of NØ (convenor) and TPMVV (methodologist). NØ and TPMVV supervised the process of the SLR. NØ organised and chaired the TF meetings. TM drafted the manuscript with advice from NØ and TPMVV. All authors have contributed to the recommendations by participating in the TF meetings; during discussion and agreement on the recommendations; revising and approving the manuscript for publication.

Funding This study was funded by European League Against Rheumatism (HPR055).

Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

Competing interests TPMVV was the Vice president EULAR health professionals 2020–2022 and is part of the EULAR Advocacy Committee 2020–present. MG holds a leadership position in OpenReuma/Spanish Association of Health Professionals in Rheumatology (unpaid). CDM received Grants from Versus Arthritis, MRC, NIHR (paid to Keele University) and is the director of the NIHR School for Primary Care Research. SL received payment as scientific consultant from Arthro Therapeutics AB and received payment from AstraZeneca as a member of DSMB. DC received grants from Fundação para a Ciência e Tecnologia SFRH/BD/148420/2019 and Pfizer (ID 64165707). GZ received payment for expert testimony from Casa di Cura San Francesco, Verona and Support for attending meetings and/or travel from Orthotech and Jtech, payment for participation on a Data Safety Monitoring Board or Advisory Board from VIVENKO for Gruenenthal and Ethos for Angelini and holds other financial interests related to clinical practice as an orthopedic surgeon (performing total joint replacement, arthroscopies and other types of surgeries), either directly from private patients or indirectly from the health system or insurances acting as a private consultant. JEV has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Lilly Netherlands BV. TG has received paid honoraria for lectures by Abbvie, Novartis, Boehringer Ingelheim, UCB, Berlin-Chemie/A. Menarini Bulgaria, Sandoz and received support for attending meetings by Abbvie, Pfizer and UCB. DW is an International Advisory Board Member of DRFZ (Germany) 2019–current and was the EULAR PARE Chair 2015–2017and an EULAR Vice President representing PARE 2017–2021.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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Prescribed Fire: Collaborative Experiences from the Forests of Alpine County

Friday, july 26th, 9:00am – 3:00pm , link to field workshop registration.

This field workshop is an opportunity to learn about prescribed burning throughout Alpine County. Participants will increase their understanding of collaborative prescribed burning programs from experiences shared working in the forests of Alpine County. 

Brian Newman, Assistant Chief of Amador-El Dorado Unit at CAL FIRE, will overview the use and significance of the CAL FIRE Vegetation Management Program (VMP) and the California Vegetation Treatment Program (CalVTP). Clint Celio, Wildfire Project Coordinator for Alpine County, will discuss some of the fire history in eastern Alpine County and the role of prescribed fire in the wildland fire restoration process. David Griffith, Alpine Biomass Collaborative Chair, Alpine County Supervisor, and Great Basin Unified Air Pollution Control District Board Member, will cover the air quality impacts from prescribed fire. Steve Howell, US Forest Service Fire Management Specialist, will examine how forests differ due to factors like management goals and historical contexts, and emphasize the importance of ongoing maintenance. Brian McMillan, Carson City Special Forest Products Manager at Bureau of Land Management, will consider the contrasting expectations for forests, particularly pointing out moisture gradients. Brian Peters, Former Community Development Director for Alpine County, will discuss the Markleevillage Fuels Reduction Project, completed in 2019. He will highlight how multiple groups, including Alpine County, Carson Ranger District, Alpine Watershed Group (AWG) and Alpine Fire Safe Council (AFSC), worked together to accomplish this project and how this work has helped to strengthen and expand collaborative efforts going forward.

Brian Newman, Assistant Chief, Amador-El Dorado Unit, East Division Operations, CAL FIRE

Brian has worked for CAL FIRE for 30 fire seasons in the Amador – El Dorado Unit. He has been assigned to various programs including Schedule A and Schedule B fire suppression, Emergency Command Centers, and the unit Vegetation Management Program / Fuels reduction program. He Graduated from Cogswell Polytechnical College with a B.S. in Fire Management and Technology. Brian’s current position is the Assistant Chief of the East Division of AEU, which includes Lake Tahoe and Alpine County and a Fire Crew fire center. Brian is a member of CAL FIRE Incident Management Team 3 as the Fire Behavior Analyst and instructs on numerous cadres including Prescribed Fire Incident Commander, and the Fire Behavior series.

Steve Howell, Fire Management Specialist, US Forest Service

Steve attended the University of Nevada Reno and graduated with a bachelor’s degree in Range Management. After graduating, he was hired full time with the US Forest Service in fire suppression working on fire engines. To date, he has 30 years with the US Forest Service. He has worked his entire career on the Humboldt-Toiyabe NF. Steve started his career in Fire Suppression, moved to Fire Prevention and then finally into Fuels Management, where currently he is the Fire Management Specialist with oversight of the Carson and Bridgeport Ranger Districts Fuels program on approximately 1,400,000 acres.

Clint Celio, Wildfire Project Coordinator, Alpine County, California

Clint Celio is the Alpine county wildfire projects coordinator. Born and raised in Alpine County, Mr. Celio earned a BS and MS from Colorado State University before returning to Alpine County to continue to serve his community. He has written the Alpine County Community Wildfire Protection Plan as well as wildfire mitigation documents for Lake Tahoe and the surrounding communities. He is a member of the local fire department, serving as assistant chief for almost 20 years. Most recently Clint took on the county coordinator position for the California Fire Safe Council program and is the project manager for the Tamarack Fire Emergency Forest Restoration Team. 

David Griffith, Alpine Biomass Collaborative Chair, Alpine County Supervisor, Great Basin Unified Air Pollution Control District Board Member

David Griffith has been an Alpine County Supervisor for over seven years as well as a member of the Board of Directors of the Great Basin Unified Air Pollution Control District. He was a founding member of the Alpine Fire Safe Council and is Chair of the Alpine Biomass Collaborative.

Brian Peters, Former Community Development Director, Alpine County, California

Brian Peters is the former Community Development Director for Alpine County, California. He retired in 2020 after 22 years with the County. Brian has over 35 years of local government experience in California and Colorado. His work focused on land use planning, development review, preparation of community plans, environmental analysis, staff reports, presentations to commissions and boards and communication of information to the public. Brian was part of a multi-agency team that planned and conducted the Markleeville Fuels Reduction Project that treated over 200 acres of National Forest System lands bordering a residential area. Since 2021 Mr. Peters has been part of a consultant team providing wildfire mitigation planning and coordination services to Alpine County under a grant from the State of California. Brian holds a Master’s in Regional Planning from Washington State University and a Bachelor’s in Forest Management from Colorado State University. Brian is a long time Alpine County resident and lives in Woodfords California.

Brian McMillan, Carson City Special Forest Products Manager, Bureau of Land Management

Biography coming soon.

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• Premium Plus Account: This plan option has over 700 total metrics, over 180 ETF-specific metrics, stock ratings, ratio charts, valuation charts, multiple fundamental metric charting, top-priority email support, equation screening, custom metrics, and higher data limits. It also provides current and past stock scoring for Value, Growth, Quality, and Sentiment. 

Screening Strategies

Stock Rover's screeners review thousands of stocks and ETFs to find the investments that best fit your risk tolerance and goals. Not only can you filter assets across hundreds of metrics, but you can also sift through more than 140 pre-built screeners in the Stock Rover library.

You can create a custom screen by modifying one of the pre-built screeners or building one from scratch. By combining more than 500 operational, financial, efficient, and rating metrics, you can screen based on value, growth, dividend growth, and other factors. 

Stock-and-ETF Comparison

Thanks to Stock Rover's comparison tool, you can compare stocks and ETFs side by side. The Table tool compares any stock or ETF you enter and organizes each according to factors like dividends, historical returns, valuation, and more.

Stock Rover's Insight panel also allows users to access company news, financial statements, cash flow, earnings transcripts, and analyst ratings. 

Stock Charting

Stock Rover's stock charting tools are ideal for those who want to compare their portfolios to benchmarks like the S&P 500 (a stock market index that tracks the performance of the largest publicly traded US companies).

These tools also allow you to chart over 100 metrics, including the price-to-earnings (P/E) ratio .

Research Reports

A Research Reports subscription provides unlimited, up-to-the-minute research on over 7,000 stocks. Reports generally contain key information on sales growth, P/E, analyst summary consensus, financial income statements, cash flow, and profitability metrics. 

If you don't want to pay for a Research Report subscription, free report PDFs on a select group of stock and market charts are updated weekly. These include reports on: 

• Johnson & Johnson
• Walt Disney

You can receive Research Reports as a PDF or in your browser. 

Portfolio Management

Stock Rover offers various portfolio management features and tools, including brokerage integration, automatic portfolio rebalancing (daily, weekly, or monthly), portfolio analysis, and the Future Income tool. The Future Income tool calculates your monthly future portfolio dividend income based on your portfolio's stocks, mutual funds, and ETFs. 

The Trade Evaluator tool allows you to analyze trades to show whether or not they have benefitted or hurt your performance. You can look at individual trades, a select group of trades, or all the trades against a specific benchmark. The Monte Carlo simulation technique can also test your investment portfolio's long-term growth through various financial scenarios. 

Stock Rover Fees

Fees will vary depending on the plan you choose. You won't pay anything for Stock Rover's standard free plan, but the premium plans will cost you. See Stock Rover's complete fees below:

• Essential Account: $7.99/month, $79.99/year, $139.99/2 years
• Premium Account: $17.99/month, $179.99/year, $319.99/2 years
• Premium Plus Account: $27.99/month, $279.99/year, $479.99/2 years

A Research Reports subscription can be bundled with a yearly or two-year Stock Rover plan for $49.99 (a Stock Rover Free plan does not qualify). Otherwise, it costs $99.99 per year. You can also pay $50 per year to add prioritized hotline telephone support.

Pros and Cons of Using Stock Rover

A notable downside of Stock Rover is its limited customer service. Account holders with a Free subscription plan are not guaranteed to get a response if they email customer support. The platform also doesn't offer a live chat feature or public phone number. You must pay an additional $50 each month to unlock prioritized hotline support.

Stock Rover Trustworthiness

Business Insider assesses company trustworthiness by reviewing each investment platform's Better Business Bureau profile. Ratings typically reflect the bureau's opinion of how well it believes a company interacts with its customers. 

Stock Rover doesn't currently have a BBB profile, but its record appears to be clear of any major public scandals or lawsuits. 

Stock Rover vs. MarketGrader

Stock Rover and MarketGrader offer a range of investment tools for research-oriented traders. But they differ when it comes to data access, fees, and accessibility. 

Stock Rover is cheaper, providing a free version and multiple paid plans. MarketGrader, however, doesn't offer a free account option (only a 14-day free trial), and the lowest plan option starts at $75 per month (or $900 per year). MarketGrader separates plans based on geographical access. If you want global access to over 90 countries and 40,000 companies, you must pay $167 per month (or $2,000 yearly). 

MarketGrader is preferred for index investing as it offers a huge lineup of global equity indexes tracked through its Smart Beta Index resources. 

Stock Rover vs. FAST Graphs

Like Stock Rover, FAST Graphs is a stock screener and analysis platform that offers portfolio tracking, charting tools, detailed forecasting of future stock returns, and analyst scorecards. 

FAST Graphs offers similar features to Stock Rover through two plan options: Basic and Premium. The cheapest plan (Basic) is $19.95 per month, which is more than double the cost of Stock Rover's cheapest paid plan. FAST Graphs doesn't have brokerage integration, a portfolio simulation feature, or as many customizable features as Stock Rover. Plus, it only screens stocks. 

Overall, Stock Rover is the stronger platform, offering more subscription options (including a free plan), ETF tracking capabilities, and more advanced charting features. However, Fast Graphs tracks more than 18,000 US and CA stocks, whereas Stock Rover only tracks 8,500. Fast Graphs may be the better option if you're only tracking stocks. 

Stock Rover FAQs

Stock Rover is an advanced stock screener and investment research platform that offers portfolio management and detailed financial statements so individual investors can thoroughly evaluate stocks, ETFs, and more. It also offers seamless brokerage integration, hundreds of financial metrics, customizable charts and screeners, and current and historical stock scoring.

Stock Rover's screening and analysis capabilities stand out as some of the most robust in the investment tool space. Investors can create custom stock and ETF screens using a range of financial metrics and historical data analysis. Stock Rover easily integrates with more than 1,000 external brokerage platforms. The free version provides powerful portfolio management and charting tools, but you can unlock even more with one of Stock Rover's competitive paid plans. 

Stock Rover offers three subscription plan options for investors, depending on their needs and preferences. Depending on your plan, you can pay as little as $7.99 per month or as much as $27.99 per month. Stock Rover also offers a free version with limited charting and screening features. The more you pay, the more advanced screening and analysis tools you'll unlock. 

Stock Rover is suitable for both novice and experienced investors as it offers a range of subscription plans with varying degrees of research and charting technology. Beginners can use Stock Rover's free or Essential subscription plan to access basic screening tools and research to help manage their portfolios. Experienced investors will benefit from Stock Rover's Premium and Premium Plus plans for a wider range of advanced charting tools, custom screeners, and in-depth market research. 

Stock Rover enhances portfolio management and tracking by seamlessly integrating with external brokerage accounts for automatic performance tracking, risk assessment, and charting capabilities. On Stock Rover, you can project your future dividend income, compare historical data of thousands of investable securities, create custom metrics, and access powerful portfolio rebalancing tools. 

Why You Should Trust Us: How We Reviewed Stock Rover

Stock Rover was reviewed using Business Insider's rating methodology for investing platforms to compare and examine pricing, accessibility, and overall customer experience. Investing platforms are given a rating between 0 and 5. 

Investment platforms usually offer multiple assets, trading tools, low fees, and other resources. Since Stock Rover isn't a brokerage and doesn't offer trading services, it was reviewed a little differently than other investing platforms. 

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