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The acceptability and feasibility of conducting a randomised controlled trial to test the effectiveness of a walking intervention for older people with persistent musculoskeletal pain in primary care: a mixed methods evaluation of the iPOPP pilot trial

The acceptability and feasibility of conducting a randomised controlled trial to test the effectiveness of a walking intervention for older people with persistent musculoskeletal pain in primary care: a mixed methods evaluation of the iPOPP pilot trial
The acceptability and feasibility of conducting a randomised controlled trial to test the effectiveness of a walking intervention for older people with persistent musculoskeletal pain in primary care: a mixed methods evaluation of the iPOPP pilot trial

Introduction: persistent musculoskeletal (MSK) pain is associated with physical inactivity in older people. While walking is an acceptable form of physical activity, the effectiveness of walking interventions in this population has yet to be established. 

Objectives: to assess the acceptability and feasibility of conducting a randomised controlled trial (RCT) to test the effectiveness of a healthcare assistant-led walking intervention for older people with persistent MSK pain (iPOPP) in primary care. 

Methods: a mixed method, three arm pilot RCT was conducted in four general practices and recruited patients aged ≥65 years with persistent MSK pain. Participants were randomised in a 1:1:1 ratio to: (i) usual care, (ii) usual care plus a pedometer intervention, or (iii) usual care plus the iPOPP walking intervention. Descriptive statistics were used in an exploratory analysis of the quantitative data. Qualitative data were analysed using thematic analysis. A triangulation protocol was used to integrate the analyses from the mixed methods. 

Results: all pre-specified success criteria were achieved in terms of feasibility (recruitment, follow-up and iPOPP intervention adherence) and acceptability. Triangulation of the data identified the need, in the future, to make the iPOPP training (for intervention deliverers) more patient-centred to better support already active patients and the use of individualised goal setting and improve accelerometry data collection processes to increase the amount of valid data. 

Conclusions: this pilot trial suggests that the iPOPP intervention and a future full-scale RCT are both acceptable and feasible. The use of a triangulation protocol enabled more robust conclusions about acceptability and feasibility to be drawn.

data triangulation, musculoskeletal pain, older people, physical activity, primary care, randomised controlled trial, walking
1478-2189
1372-1386
Healey, Emma L.
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McBeth, John
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Nicholls, Elaine
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Chew-Graham, Carolyn A.
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Dent, Stephen
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Foster, Nadine E.
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Herron, Daniel
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Pincus, Tamar
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Hartshorne, Liz
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Hay, Elaine M.
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Jinks, Clare
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Healey, Emma L.
c9b21020-158e-4af5-8963-2c919ff0d9ad
McBeth, John
98012716-66ba-480b-9e43-ac53b51dce61
Nicholls, Elaine
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Chew-Graham, Carolyn A.
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Dent, Stephen
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Foster, Nadine E.
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Herron, Daniel
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Pincus, Tamar
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Hartshorne, Liz
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Hay, Elaine M.
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Jinks, Clare
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Healey, Emma L., McBeth, John, Nicholls, Elaine, Chew-Graham, Carolyn A., Dent, Stephen, Foster, Nadine E., Herron, Daniel, Pincus, Tamar, Hartshorne, Liz, Hay, Elaine M. and Jinks, Clare (2023) The acceptability and feasibility of conducting a randomised controlled trial to test the effectiveness of a walking intervention for older people with persistent musculoskeletal pain in primary care: a mixed methods evaluation of the iPOPP pilot trial. Musculoskeletal Care, 21 (4), 1372-1386. (doi:10.1002/msc.1815).

Record type: Article

Abstract

Introduction: persistent musculoskeletal (MSK) pain is associated with physical inactivity in older people. While walking is an acceptable form of physical activity, the effectiveness of walking interventions in this population has yet to be established. 

Objectives: to assess the acceptability and feasibility of conducting a randomised controlled trial (RCT) to test the effectiveness of a healthcare assistant-led walking intervention for older people with persistent MSK pain (iPOPP) in primary care. 

Methods: a mixed method, three arm pilot RCT was conducted in four general practices and recruited patients aged ≥65 years with persistent MSK pain. Participants were randomised in a 1:1:1 ratio to: (i) usual care, (ii) usual care plus a pedometer intervention, or (iii) usual care plus the iPOPP walking intervention. Descriptive statistics were used in an exploratory analysis of the quantitative data. Qualitative data were analysed using thematic analysis. A triangulation protocol was used to integrate the analyses from the mixed methods. 

Results: all pre-specified success criteria were achieved in terms of feasibility (recruitment, follow-up and iPOPP intervention adherence) and acceptability. Triangulation of the data identified the need, in the future, to make the iPOPP training (for intervention deliverers) more patient-centred to better support already active patients and the use of individualised goal setting and improve accelerometry data collection processes to increase the amount of valid data. 

Conclusions: this pilot trial suggests that the iPOPP intervention and a future full-scale RCT are both acceptable and feasible. The use of a triangulation protocol enabled more robust conclusions about acceptability and feasibility to be drawn.

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e-pub ahead of print date: 9 September 2023
Published date: December 2023
Additional Information: Publisher Copyright: © 2023 The Authors. Musculoskeletal Care published by John Wiley & Sons Ltd.
Keywords: data triangulation, musculoskeletal pain, older people, physical activity, primary care, randomised controlled trial, walking

Identifiers

Local EPrints ID: 491495
URI: http://eprints.soton.ac.uk/id/eprint/491495
ISSN: 1478-2189
PURE UUID: d01efb10-223d-49b8-b064-e3b7de40b416
ORCID for John McBeth: ORCID iD orcid.org/0000-0001-7047-2183
ORCID for Tamar Pincus: ORCID iD orcid.org/0000-0002-3172-5624

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Date deposited: 25 Jun 2024 16:42
Last modified: 26 Jun 2024 02:11

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Contributors

Author: Emma L. Healey
Author: John McBeth ORCID iD
Author: Elaine Nicholls
Author: Carolyn A. Chew-Graham
Author: Stephen Dent
Author: Nadine E. Foster
Author: Daniel Herron
Author: Tamar Pincus ORCID iD
Author: Liz Hartshorne
Author: Elaine M. Hay
Author: Clare Jinks

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