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Supported self-management for all with musculoskeletal pain: an inclusive approach to intervention development: the EASIER study

Healey, Emma L.; Lewis, Martyn; Corp, Nadia; Shivji, Noureen A.; van der Windt, Danielle A.; Babatunde, Opeyemi O.; Simkins, Joanna; Bartlam, Bernadette; Rowlands, Gill; Protheroe, Joanne


Bernadette Bartlam

Gill Rowlands


Supported self-management interventions for patients with musculoskeletal (MSK) conditions may not adequately support those with limited health literacy, leading to inequalities in care and variable outcomes. The aim of this study was to develop a model for inclusive supported self-management intervention(s) for MSK pain that take account of health literacy.

A mixed methods study with four work-packages was conducted: work package 1: secondary analysis of existing data to identify potential targets for intervention; work package 2: evidence synthesis to assess effective components of self-management interventions taking into account health literacy; work package 3: views of community members and healthcare professionals (HCPs) on essential components; work package 4: triangulation of findings and an online modified Delphi approach to reach consensus on key components of a logic model.

Findings identified targets for intervention as self-efficacy, illness perceptions, and pain catastrophizing. A range of intervention components were identified (e.g. information in diverse formats offered at specific times, action planning and visual demonstrations of exercise). Support should be multi-professional using a combination of delivery modes (e.g. remote, face-to-face).

This research has developed a patient-centred model for a multi-disciplinary, multi-modal approach to supported self-management for patients with MSK pain and varying levels of health literacy. The model is evidence-based and acceptable to both patients and HCPs, with potential for significant impact on the management of MSK pain and for improving patient health outcomes. Further work is needed to establish its efficacy.

Journal Article Type Article
Acceptance Date Apr 21, 2023
Online Publication Date Jun 10, 2023
Publication Date Jun 10, 2023
Deposit Date Jun 14, 2023
Publicly Available Date Jun 14, 2023
Journal BMC Musculoskeletal Disorders
Print ISSN 1471-2474
Electronic ISSN 1471-2474
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 24
Issue 1
Article Number 474
Keywords Health Literacy, Musculoskeletal Pain, Mixed-methods, Logic Model, Supported Self-management, Humans, Health Personnel, Self-Management
PMID 37301959
Additional Information Received: 10 November 2022; Accepted: 21 April 2023; First Online: 10 June 2023; : ; : All methods were carried out in accordance with relevant guidelines and regulations (e.g. Helsinki declaration). All participants in work package 3 and 4 provided written informed consent. Ethical approval was obtained from Keele University’s Faculty of Medicine and Health Sciences Research Ethics Committee (ref: MH-190101).; : Not applicable.; : The authors declare no competing interests.


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