Personalised Exercise-rehabilitation for People With Multiple Long-term Conditions (PERFORM): A Randomised Feasibility Study

RATIONALE: Exercise-based rehabilitation interventions are beneficial for a variety of long-term conditions (LTC). Currently, services are centred around single conditions (e.g., pulmonary or cardiac) and may not meet the complex needs of those with multiple LTC (MLTC). The aim was to determine the feasibility of a newly developed personalised exercise-rehabilitation programme for people with MLTC (PERFORM). METHODS: A parallel two-group randomised mixed-methods feasibility study was conducted across 3 sites in the UK. Adults with MLTC (2 or more, with at least one from a prespecified list [1]) were randomly assigned in a 2:1 ratio to either the PERFORM intervention plus usual care (intervention) or usual care alone (control). The novel and bespoke PERFORM intervention consisted of an 8-week supervised group-based rehabilitation (aerobic and resistance exercises) and self-care support programme. Primary feasibility outcomes were based on prespecified progression criteria to a randomised controlled trial (RCT) i.e., trial recruitment (percentage recruitment target [60] met within the 4.5-month window), retention (percentage of randomised participants with complete EuroQol 5-Dimensions [EQ-5D] data), and intervention adherence (percentage of participants allocated to PERFORM intervention attending ≥60% sessions). The proposed primary outcome for the future RCT (EQ-5D Utility Index) and other secondary outcomes were assessed at baseline and 3-month follow-up. RESULTS: Recruitment rate reached 100% of target (60/60; 40 in PERFORM, 20 in control) within the 4.5-month recruitment window: 57% female; mean (SD) age, 62 (13) years; BMI, 30.8 (8.0). The median number of conditions, reported by participants, was 4, with the most prevalent being diabetes (41.7%), hypertension (38.3%), asthma (36.7%), and a painful condition (35.0%). Overall, 46/60 participants (76.7%) attended the 3-month follow-up assessment and had complete EQ-5D data. 29/40 (72.5%) participants attended ≥60% sessions (≥9/14 sessions). Patient reported secondary outcomes at 3-month follow up showed a trend toward greater improvement in the PERFORM intervention compared to control group (Table 1). CONCLUSION: Our study shows that the PERFORM intervention was feasible and acceptable, and supports continuance to a fully powered multicentre RCT of the PERFORM intervention compared to usual care to formally assess clinical- and cost-effectiveness. 1. Dibben, G. O., Gardiner, L., Ml, H., Wells, Y. V., Evans, R. A., Ahmed, Z., ... & Taylor, R. S. (2024). Evidence for Exercise-Based Interventions across 45 Different Long-Term Conditions: An Overview of Systematic Reviews. eClinicalMedicine.