Joint protection is a self-management strategy aimed at preserving function and energy conser- vation through modi!cation in working habits, enhanced awareness of posture and joint position, use of proper joint and body mechanics by applying ergonomic principles, activity pacing, environmental adaptation, and the use of orthotic and assistive devices.Furthermore, clinical heterogeneity is contributed by the characteristics of the RA patient and the disease trajectory.The provision of TPE programs can be delivered by various health professionals such as nurses, occupational therapists, physiotherapists, psychologists, social workers, podiatrists as well as rheu- matologists, and physical and rehabilitation medicine physicians [33].A recent RCT has revealed that needs-based patient education, using the Educational Needs Assessment Tool for guidance, helps to improve patients' self-ef!cacy and some aspect of health status [40].The !rst one reported moderate evidence to improve joint pro- tection behaviors, whereas low evidence to improve pain and physical function [34].