The OPTIMAL study: A randomized controlled trial and process evaluation of an OccuPaTIonal therapy led self MAnagement support programme for patients with muLtimorbidity in primary care

Many people with chronic disease tend to have more than one chronic condition, referred to as multimorbidity. It is predicted that the number of individuals with multimorbidity is set to increase substantially in the future due to the growing elderly population. Those with multimorbidity experience poor physical function and find it difficult to engaging in day-to-day activities. This results in increased frustration, poor psychological well-being and increased health care utilisation. There is a lack of intervention targeting those with multimorbidity and focusing on enabling individuals participate in the activities they want and need to do.
The aim of this group is to improve participant's self-management of their conditions and increase engagement in valued activities. An occupational therapy (OT) group-based intervention for individuals with multimorbidity, or OPTIMAL, will examine the effectiveness of this study.
This study plans to do this by facilitated a 6-week period for an OT team to focuses on educating participants on issues such as; activity and health, physical activity, fatigue management, nutrition, maintaining mental well-being, medication management and communicating effectively with health care providers. Participants set weekly goals to participate in activities and implement strategies to manage their conditions.
The OT teams observed results from both pilot studies, based in Dublin primary care settings, suggested significant improvements in activity, quality of life, perceptions of performance and satisfaction with activities and self-efficacy in managing chronic conditions. Primary care OTs reported that the programme delivered was useful and feasible for those with multimorbidity.
Building from these promising results, the proposed study is a definitive randomised controlled trial to provide more evidence on the effectiveness of this intervention for participants' quality of life, frequency of activity participation, their perceptions of their ability to perform activities, their satisfaction with their performance, their confidence in managing their conditions and mood. This study will also involve analysing the experiences of those delivering the intervention and the relative ease and efficiency for them to administer the program.


Award Date
14 May 2016
Award Value
Principal Investigator
Ms Lynn O'Toole
Host Institution
Trinity College Dublin
Research Training Fellowships for Healthcare Professionals