چکیده (انگلیسی):

Background:We investigated the effectiveness of an occupational therapy led self-management support programme,
OPTIMAL, designed to address the challenges of living with multiple chronic conditions or multimorbidity in a primary
care setting.
Methods:Pragmatic feasibility randomised controlled trial including fifty participants with multimorbidity recruited from
family practice and primary care settings. OPTIMAL is a six-week community-based programme, led by occupational
therapy facilitators and focuses on problems associatedwith managing multimorbidity. The primary outcome was
frequency of activity participation. Secondary outcomes included self-perception of, satisfaction with and ability to
perform daily activities, independence in activities of daily living, anxiety and depression, self-efficacy, health-related quality
of life, self-management support, healthcare utilisation and individualised goal attainment. Outcomes were collected
within two weeks of intervention completion.
Results:There was a significant improvement in frequency of activity participation, measured using the Frenchay
Activities Index, for the intervention group compared to the control group (Adjusted Mean Difference at follow up
4.22. 95% Confidence Interval 1.59-6.85). There were also significant improvements in perceptions of activity
performance and satisfaction, self-efficacy, independencein daily activities and quality of life. Additionally, the
intervention group demonstrated significantly higher levels of goal achievement, following the intervention. No
significant differences were found between the two groups in anxiety, depression, self-management scores or
healthcare utilisation.
Conclusions:OPTIMAL significantly improved frequency of activity participation, self-efficacy and quality of life for
patients with multimorbidity. Further work is required totest the sustainability of these effects over time but this
study indicates that it is a promising intervention that can be delivered in primary care and community settings.
Trial registration:Trial Number: ISRCTN67235963