International multimorbidity

Title

The MOBILIZE project: Personalized exercise therapy and self-management support for people with multimorbidity and potential for collaboration.

Authors

Alessio Bricca^1,2 and Søren T. Skou^1,2

Affiliations

¹ Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark

² The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark

 

Introduction

Despite its prevalence and significant impact on both individuals and society, effective management strategies for multimorbidity remain elusive. The EU funded MOBILIZE project (https://www.mobilize-project.dk/?lang=en) (grant agreement No 801790) seeks to bridge this gap by investigating the potential benefits and harms of personalized exercise therapy and self-management support in addition to usual care for individuals with multimorbidity.

We are pleased to share that we have completed the 12-month outcome data collection for our randomised controlled trial. We are now working on analysing the results, in line with our statistical analysis plan, and look forward to sharing our findings soon.

 

Objective of the MOBILIZE Project

The primary objective of the MOBILIZE project is to evaluate the 12-month effects of a personalized exercise therapy and self-management support program on individuals with multimorbidity. This intervention is designed to be an adjunct to usual care, aiming to enhance health outcomes through tailored support. By focusing on a holistic approach that combines physical activity with self-management support, the project seeks to address both the physical and psychological aspects of multimorbidity.

 

Study Design and Methodology

The MOBILIZE project followed the MRC framework to co-develop and test the effectiveness and cost-effectiveness of a personalised exercise therapy and self-management intervention. We conducted several studies including: one scoping review, five systematic reviews, two registry-based studies, one qualitative interview study and a mixed-methods feasibility study, as well as a protocol paper for the randomised controlled trial (with all outcomes presented) and the statistic for testing the effectiveness of the MOBILIZE intervention.

 

The randomised controlled trial

The randomised controlled trial testing the co-developed intervention adopts a pragmatic, parallel-group, superiority design, involving 228 participants aged 18 and older with multimorbidity. Adults (aged 18 years or above) with at least two of the following chronic conditions: knee or hip osteoarthritis, chronic obstructive pulmonary disease, heart disease (heart failure or chronic heart disease), hypertension, type 2 diabetes mellitus and depression were recruited from six general practitioners, three psychiatric facilities, and seven hospital departments in the Region of Zealand, Denmark, through direct consultations, Facebook ads and local newspaper articles as well as other advertisement and posters/handouts.. They were randomly assigned in a 1:1 ratio to either the control group, which received usual care, or the intervention group, which received usual care plus a 12-week personalized exercise therapy and self-management support program. The intervention sites include two hospitals, a private physiotherapy clinic, and two municipal rehabilitation centres, ensuring a diverse representation of healthcare settings.

 

Intervention Details

The intervention program is meticulously designed to cater to the unique needs of individuals with multimorbidity. It includes personalized exercise regimens tailored to each participant’s specific conditions and physical capabilities as well as their preferences. Alongside exercise therapy, the program offers self-management support to empower participants to take control of their health. This comprehensive support program includes education on managing their conditions, coping strategies, and tools to improve adherence to treatment plans. The goal is to enhance participants' physical and psychological health. For further details on the intervention see the intervention development paper.

 

Patient Involvement

Patient involvement is a cornerstone of the MOBILIZE project. From the start, the project has included at least two individuals with multimorbidity and one partner of a patient in key meetings and decision-making processes. This approach follows the 'Collaborate' level on the IAP2 Spectrum of Public Participation, emphasizing active partnership. These patient partners share their experiences, needs, and preferences, ensuring that the exercise therapy and self-management support program is patient centred. Their input helps tailor the interventions to address the specific challenges faced by those with multimorbidity, enhancing relevance and effectiveness.

 

Knowledge dissemination

We look forward to sharing the findings of the RCT. They will be disseminated through scientific publications, conference presentations, and public outreach initiatives to ensure a wide dissemination of the results. We have already produced several podcasts, blog articles and workshops and presentation at social events in Denmark.

This commitment to transparency and broad communication underscores the project’s goal of influencing clinical practice and improving patient outcomes.

 

Conclusion

The MOBILIZE project represents a significant step forward in the quest to improve the management of multimorbidity. By rigorously evaluating the benefits and potential risks of a personalized exercise therapy and self-management support program, this study aims to identify effective strategies to enhance the quality of life for those living with multiple chronic conditions.

 

Potential to collaborate

We invite researchers from around the world who are interested in utilizing the MOBILIZE data for specific research purposes to contact us. For a full list of outcomes see our protocol paper.

 

Contact us

For further information on the MOBILIZE project, please contact:

 

Søren Thorgaard Skou

Principal investigator, Professor, Physiotherapist, PhD

Næstved-Slagelse-Ringsted Hospitals and University of Southern Denmark

 

Tel: +4523708640

Email: stskou@health.sdu.dk

X: @MobilizeDk

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First published: 5 August 2024