{
  "abstract": "Objective The number of people living with multiple long-term conditions (MLTCs or ‘multimorbidity’) is growing. Evidence indicates that exercise-based rehabilitation can improve health-related quality of life and reduce hospital admissions for a number of single long-term conditions. However, it is increasingly recognised that such condition-focused rehabilitation programmes do not meet the needs of people living with MLTCs. The aims for this study were to (1) evaluate the acceptability and feasibility of the newly developed Personalised Exercise Rehabilitation FOR people with Multiple long-term conditions (PERFORM) intervention; (2) assess the feasibility of study methods to inform progression to a definitive randomised controlled trial (RCT) and (3) refine our intervention programme theory.Design Semi-structured qualitative interviews were conducted with patients receiving and healthcare practitioners delivering the PERFORM intervention, to seek their experiences of the intervention and taking part in the study. Interviews were analysed thematically, informed by Normalisation Process Theory and the programme theory.Setting Three UK sites (two acute hospital settings, one community-based healthcare setting).Participants 18 of the 60 PERFORM participants and 6 healthcare professionals were interviewed.Intervention The intervention consisted of 8 weeks of supervised group-based exercise rehabilitation and structured self-care symptom-based support.Results All participants and staff interviewed found PERFORM useful for physical and mental well-being and noted positive impacts of participation, although some specific modifications to the intervention delivery and training and study methods were identified. Scheduling, staffing and space limitations were barriers that must be considered for future evaluation and implementation. Key intervention mechanisms identified were social support, patient education, building routines and habits, as well as support from healthcare professionals.Conclusions We found the PERFORM intervention to be acceptable and feasible, with the potential to improve the health and well-being of people with MLTCs. The findings of the process evaluation inform the future delivery of the PERFORM intervention and the design of our planned full RCT. A definitive trial is needed to assess the clinical and cost-effectiveness.Trial registration number ISRCTN68786622.",
  "authors": [
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Sophie Eleanor Brown"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Sharon Anne Anne Simpson"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "Colin Greaves"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "Paulina Daw"
    },
    {
      "affiliations": [
        "Medical School, University of Exeter, Exeter, UK"
      ],
      "name": "Sarah Gerard Dean"
    },
    {
      "affiliations": [
        "Respiratory Sciences, University of Leicester, Leicester, UK",
        "Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, UK"
      ],
      "name": "Rachael A Evans"
    },
    {
      "affiliations": [
        "School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK"
      ],
      "name": "Tom M Withers"
    },
    {
      "affiliations": [
        "Respiratory Sciences, University of Leicester, Leicester, UK",
        "Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, UK"
      ],
      "name": "Zahira Ahmed"
    },
    {
      "affiliations": [
        "Leicester Clinical Trials Unit, University of Leicester, Leicester, UK"
      ],
      "name": "Shaun Barber"
    },
    {
      "affiliations": [
        "Leicester Clinical Trials Unit, University of Leicester, Leicester, UK"
      ],
      "name": "Gwen Barwell"
    },
    {
      "affiliations": [
        "Health Sciences, University of York, York, UK"
      ],
      "name": "Patrick Joseph Doherty"
    },
    {
      "affiliations": [
        "University Hospitals of Leicester NHS Trust, Leicester, UK"
      ],
      "name": "Nikki Gardiner"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Tracy Ibbotson"
    },
    {
      "affiliations": [
        "General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Bhautesh Jani"
    },
    {
      "affiliations": [
        "Department of Applied Health Research, University of Birmingham, Birmingham, UK"
      ],
      "name": "Kate Jolly"
    },
    {
      "affiliations": [
        "General Practice and Primary Care, School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Frances Mair"
    },
    {
      "affiliations": [
        "Respiratory Sciences, University of Leicester, Leicester, UK",
        "Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, UK"
      ],
      "name": "James R Manifield"
    },
    {
      "affiliations": [
        "Health Economics and Health Technology Assessment (HEHTA), University of Glasgow, Glasgow, UK"
      ],
      "name": "Emma McIntosh"
    },
    {
      "affiliations": [
        "University of Leicester, Leicester, UK"
      ],
      "name": "Daniel Miller"
    },
    {
      "affiliations": [
        "School of Health and Society, University of Salford, Salford, UK"
      ],
      "name": "Paula Ormandy"
    },
    {
      "affiliations": [
        "School of Medicine, Trinity College Dublin, Dublin, Ireland"
      ],
      "name": "Susan Smith"
    },
    {
      "affiliations": [
        "Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK"
      ],
      "name": "Ioannis Vogiatzis"
    },
    {
      "affiliations": [
        "Leicester Clinical Trials Unit, University of Leicester, Leicester, UK"
      ],
      "name": "Ghazala Waheed"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK",
        "Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK"
      ],
      "name": "Rod Taylor"
    },
    {
      "affiliations": [
        "Respiratory Sciences, University of Leicester, Leicester, UK",
        "Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, UK",
        "University Hospitals of Leicester NHS Trust, Leicester, UK"
      ],
      "name": "Sally J Singh"
    },
    {
      "affiliations": [],
      "name": "on behalf of the PERFORM research team"
    }
  ],
  "title": "Personalised Exercise Rehabilitation FOR people with Multiple long-term conditions (PERFORM): findings from a process evaluation of a randomised feasibility study",
  "uid": "6d3262d6-9530-5ec2-bcfd-4284411c56c4"
}