OptiMaL: A PRIMARY CARE-BASED INTERVENTION FOR PEOPLE WITH MULTIMORBIDITY

Background: Interventions are needed to improve health outcomes for individuals with multimorbidity. A six-week occupation-focused, self-management programme (OptiMaL) was designed based on the Stanford model (Lorig, et al.,... [ view full abstract ]

Background:
Interventions are needed to improve health outcomes for individuals with multimorbidity. A six-week occupation-focused, self-management programme (OptiMaL) was designed based on the Stanford model (Lorig, et al., 1999) to increase occupational participation. A randomised controlled trial investigated the effectiveness of OptiMaL in a primary care setting.
Method:
Fifty participants were randomised to an intervention (n=26) or waiting-list control group (n=24). The primary outcome was frequency of occupational participation. Secondary outcomes included satisfaction with occupational performance, self-efficacy, quality of life, anxiety and depression, impact of health education on self-management and health care utilisation.
Results: A multiple linear regression model showed significant improvements in frequency of occupational participation for the intervention group (p=0.003). There was also a significant difference between the groups for occupational performance (p<0.001) and satisfaction with same (p<0.001), self-efficacy (p<0.001), quality of life (p=0.001) and positive and active engagement in life (p=0.002). There were no significant differences in mood or health care utilisation.
Conclusion: OptiMaL significantly improved the frequency of occupational participation which is an important components of effective self-management of chronic diseases. The trial contributes evidence on the effectiveness of an intervention for patients with multimorbidity which can be implemented at primary care.
Application to Practice:
The results of this study support the role of occupational therapists in designing and delivering self-management programmes for those with single and multiple chronic diseases.