Developing a self-management support intervention for older adults living with osteoarthritis and multiple long-term conditions

Background Osteoarthritis (OA) affects over half of people over the age of 65, and many live with other multiple long-term conditions (MLTC). Existing self-management interventions for OA do not adequately address the complexities of MLTC and there is a lack of holistic and coordinated provision across health services. Objective To develop a personalised self-management support intervention for adults aged 65 + with knee and/ or hip OA living with MLTC, receiving care in the NHS. Methods We used a six-step intervention mapping approach supplemented by co-design activities. Thirty adults (28 living with OA and MLTCs and two carers) participated in consultations and workshops, contributing their lived experiences and preferences to shape the intervention’s development and implementation. Results The emerging intervention was informed by nine core principles to address the physical, emotional, and psychological symptoms associated with the interplay between OA and MLTC. The intervention aimed to enhance individuals’ knowledge, confidence, and self-management capabilities to interact with health and care professionals and support informed decision making about their health and care. The intervention comprised (1) personalised coaching delivered by trained healthcare professionals to reflect self-management support in the context of living with OA and MLTCs supported by (2) a co-designed ‘Living well with Joint Pain’ handbook. A fidelity checklist was developed to evaluate whether the intervention underpinned by the nine core principles was delivered as intended in subsequent effectiveness evaluations. Conclusion The clinical and cost effectiveness of the intervention will now be evaluated in a randomised controlled trial comparing it to treatment as usual across the UK.