Persistent musculoskeltal pain Musculoskeletal Diseases
Conditions
Interventions
Participants will be individually randomised to one of the three arms of the study (allocation 1:1:1 ratio), using random permuted blocks, stratified by general practice.
Usual primary care:
Partici
Sponsors
Keele University
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Aged 65 years and over 2. Consulted at general practice for musculoskeletal pain in one or more index sites (foot, knee, hip, back, shoulder, neck) in the last 12 months 3. Registered with one of the participating GP practices during the specified trial period for that practice 4. Pain that has lasted for > 3 months and a current Chronic Pain Grade (Von Korff et al., 1992) score of between 2 to 4, determined through a brief postal chronic pain screening survey
Exclusion criteria
Exclusion criteria: 1. Patients with complex medical conditions deemed at risk of walking-related complications (e.g. new onset chest pain (within the last 3 months, chest pain on exercise, severe hypertension, syncope (within the last 12 months), recent lower limb fracture (within the last three months), active and severe synovitis 2. Vulnerable patients (i.e. patients with significant cognitive impairment (e.g. dementia; psychotic illness), or in palliative stage of care) 3. Patients who reside in a residential or nursing homes 4. Unable to provide full, informed, written consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Average daily step count per day over 7 days measured via accelerometry on four occasions (baseline, 3, 6 and 12 months post randomisation) | — |
Secondary
| Measure | Time frame |
|---|---|
| Measured at baseline, 3, 6 and at least 12 months follow up, except where specified differently: 1. Pain intensity and location, measured using the Numeric Pain Intensity Scale, pain manikin 2. Physical function, measured using the PF-10 from the SF-36 3. Physical activity, measured using IPAQ-E 4. Sedentary time, measured using accelerometry 5. Health-related quality of life, measured using EQ-5D-5L 6. Non-health aspects of quality of life, measured using ICECAP-O 7. Self-efficacy, measured using Self-Efficacy for Exercise Scale 8. Anxiety, measured using GAD-7 9. Depression, measured using PHQ 8 10. Healthcare resource use, measured using patient self -reported questionnaires at 6 and 12 months follow-up 11. Adverse events, measured using patient self -reported questionnaires at 3,6 and 12 months follow-up 12. Pedometer use, measured using patient self -reported questionnaires at 3,6 and 12 months follow-up 13. Consultation experience (iPOPP intervention only), measured using patient self -reported questionnaires at 3 month follow-up | — |
Countries
England, United Kingdom
Outcome results
None listed