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

Abstract

Background
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.

Methods
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
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).

Conclusions
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
• DOI: https://doi.org/10.1186/s12891-023-06452-4
• 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.