Co-designed self-management support takes shape for older adults with osteoarthritis and multiple conditions

Older adults living with osteoarthritis often manage more than painful joints. More than half of people over the age of 65 are affected by osteoarthritis, and many of them also live with several other long-term conditions at the same time. Existing self-management interventions for osteoarthritis, researchers report, do not adequately address the complexities that arise when joint disease is combined with multiple long-term conditions, and there is a lack of holistic and coordinated provision across health services. A team working in the UK has now set out to build a personalised self-management support intervention specifically for adults aged 65 and over with knee or hip osteoarthritis who live with multiple long-term conditions and receive their care in the NHS.

The development followed a six-step intervention mapping approach, a structured framework for designing health interventions, supplemented by co-design activities. Thirty adults took part in consultations and workshops: 28 of them were living with osteoarthritis and multiple long-term conditions, and two were carers. Their lived experiences and preferences directly shaped how the intervention was developed and how it is intended to be implemented.

The emerging intervention rests on nine core principles addressing the physical, emotional and psychological symptoms associated with the interplay between osteoarthritis and other long-term conditions. Its stated aim is to enhance individuals’ knowledge, confidence and self-management capabilities so they can interact with health and care professionals and support informed decision making about their own health and care. In practice, the intervention comprises two components: personalised coaching delivered by trained healthcare professionals, reflecting self-management support in the context of living with osteoarthritis alongside multiple conditions, and a co-designed handbook titled ‘Living well with Joint Pain’.

A notable technical element of the development work is a fidelity checklist, created to evaluate whether the intervention, as underpinned by the nine core principles, is actually delivered as intended in subsequent effectiveness evaluations. The checklist is intended to support the consistency of delivery when the programme is tested, so that any measured effects can be interpreted against what was actually provided to participants.

The team is careful about what has and has not been established. The published work describes the development of the intervention, not a test of whether it works. The clinical and cost effectiveness of the programme will now be evaluated in a randomised controlled trial comparing it with treatment as usual across the UK. Until those trial results are available, the intervention remains a carefully specified and co-designed candidate rather than a proven therapy. The article was published open access in BMC Geriatrics on 24 October 2026, with the accepted version shared early to provide faster access to peer-reviewed research; the authors note that this version is subject to further edits and will be replaced by the final Version of Record.

Subject of Research: Developing a self-management support intervention for older adults living with osteoarthritis and multiple long-term conditions

Article Title: Developing a self-management support intervention for older adults living with osteoarthritis and multiple long-term conditions

Article References: Button, K., Otter, P., Deere, R., Jones, F., & Busse, M. (2026). Developing a self-management support intervention for older adults living with osteoarthritis and multiple long-term conditions. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08528-x

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08528-x

Keywords: Developing, self-management, support, intervention, older, adults, living, osteoarthritis, multiple, long-term, conditions, scientific research