Title: Developing peer Mentorship to Improve self-management of Osteoarthritis: A feasibility study (aMIgO)
Funder: Department of Health and Social Care

Abstract: Background: Osteoarthritis (OA) is one of the commonest musculoskeletal conditions and is prevalent in the older population. Pain, reduced physical functioning and poor quality of life are the most common symptoms individuals with OA experience and often difficult to manage effectively. Public health policy has highlighted the need for increased self-management of long-term conditions and the provision of support for people to take care of their own health. There is evidence that peer support models can assist with improving management of long-term conditions. Aim: The aim of this research will be to develop and evaluate a peer support model (OA mentor) to improve self-management of individuals with OA. The specific objectives of the research are: To develop peer mentorship training for the OA mentors; To train volunteers to deliver peer-to-peer support to individuals with OA; To assess the feasibility of delivering peer mentorship (OA mentor providing 8 weekly sessions) at home; To assess the acceptability of this intervention to individuals with OA; To assess the feasibility and acceptability of the key trial components (timing for delivering the intervention; recruitment process; and outcome measurement tools); To understand eligibility, consent, recruitment and retention rates and rate of recruitment; To estimate completion rates for proposed effect outcome measurement tools and resource use instruments at baseline and follow up; To determine the sample size needed for a definitive randomised control trial; To estimate the cost of delivering the intervention; To provide a descriptive report on the types of resources used (and the number of contacts) and the impact on HRqOL. Plan of Investigation: This study is designed as a feasibility study using the MRC complex framework as the theoretical basis. A literature review of peer support interventions and training packages and interviews with patients, healthcare professionals and individuals representing arthritis organisations will guide the development of the peer mentor programme. Peer mentors will be trained and will be paired up with a mentee who will receive face-to-face support over 8 weeks. An exploratory feasibility trial will be conducted which will involve both qualitative and quantitative data collection. This will test the feasibility and acceptability of this intervention; assess the potential of this peer mentoring intervention for OA patients at home; and refine the trial procedures for a definitive RCT. Summary of Benefits: With our ageing population, increasing prevalence of OA and the over-burden on GPs and community musculoskeletal services, we need to develop robust, sustainable and cost-effective interventions, which focus on improving self-management of OA enabling individuals to manage more effectively their OA. The intervention has the potential to provide the additional support and guidance individuals with OA require for more effective management of their OA. The potential benefits for patients are improvements in self-management ability, self-efficacy and health-related quality of life; better management of pain; and a decrease in anxiety. It will enable less social isolation and may even encourage those receiving peer mentorship to become peer mentors in the future.

Lay abstract: Osteoarthritis (OA) is a musculoskeletal condition and is common in older people. The symptoms, which individuals often experience are high levels of pain, stiffness and a reduction in their physical ability. Their quality of life is often affected and individuals can feel socially isolated. The government has highlighted the need for individuals to manage their long-term condition themselves by providing the support for people to take care of their own health. There is evidence that peer support can assist with improving management of long-term conditions. A peer mentor is usually someone who has the condition but has undergone training to be able to provide focused assistance and mentorship to someone who also has the condition. Peer mentorship appears to work well with supporting individuals with other conditions such as diabetes and in mental health but it hasn t been developed or tested for individuals with osteoarthritis, only for inflammatory arthritis. Therefore, the aim of this research will be to develop and evaluate a peer support model (OA mentor) to improve self-management of individuals with OA through a feasibility study. The intervention will be delivered over 8 weeks with a 6-month follow-up and we will develop and refine the intervention and then evaluate how feasible and acceptable this peer support model is with individuals with OA. We know from discussions with patients who have OA that they have a need for someone other than a health professional who could support them in managing more effectively their symptoms and this is how this project has developed. We will work with individuals with OA to develop the peer mentorship model for individuals with OA and ensure it is of value to them in improving their self-management. In addition, it will inform the development of a future clinical trial.

Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL