Adapting the Fibromyalgia self-management programme to develop an online support package, optimising engagement and uptake of the intervention.

Introduction Fibromyalgia (FM) is a long-term condition that causes pain and fatigue. The condition is common, and estimates suggest it affects approximately 5% of the population. FM is more common in females and is associated with various health conditions. Unfortunately, the cause of FM is poorly understood, and as a result, diagnosing and treating the condition can be challenging. The treatment of FM includes both medicines and other non-medicine-based interventions, and current guidelines suggest that exercise and self-management strategies should be used in the first instance. The Fibromyalgia Self-Management Programme (FSMP) is a clinically developed exercise and education group intervention. The programme aims to provide FM-specific education and exercise advice and support the skills to self-manage. Currently, the FSMP is delivered by a team of specialist Rheumatology Occupational Therapists (OTs) and Physiotherapists (PTs) in Bath and a Community Therapy team in Southampton. Traditionally, the FSMP has been delivered face-to-face, but since the COVID-19 pandemic, the clinical teams have adapted the FSMP to enable virtual delivery and now offer both a virtual and face-to-face programme. However, the supporting information has not been adapted for online use. The study aims to develop an online resource to support the FSMP in the NHS so it can be delivered virtually, face-to-face or independently. I plan to ask adults with FM what information is needed to develop this resource, and then it will be tested to see if it works in clinical practice. Design and methods There are three work packages in the study. In work package one (WP1), I will explore what adults with FM would like from an online resource. To do this, I will summarise the evidence in the literature on existing online self-management programmes for FM. Then, I will conduct several focus groups with adults living with FM and the therapists delivering the FSMP. These focus groups will explore the information adults with FM need to manage FM successfully, how they might like to use the information provided in the FSMP, and the online features that would help support the delivery of the programme. Finally, at the end of WP1, I will work with a web development team to create an online FSMP resource. In work package two (WP2), I will ask people living with FM to use the online FSMP resource to see what works well and needs improvement. To do this, I will conduct a series of interviews with people about their views and experiences while using it. These interviews will help the web development team refine the online resource until it is ready to be tested. Finally, the online FSMP resource will be tested in work package three (WP3). Adults living FM who are referred to Bath or Southampton FSMP will be invited to use the online resource while attending the programme. I will also invite adults living with FM to use it independently without input from the therapy team. Once completed, I will explore both participants' and clinicians' experiences of using it. Information gathered in WP3 will help design a future research study. Patient and Public Involvement (PPI) People living with FM have assisted with the development of this research application. I will consult PPI representatives throughout the study for the planned research and seek advice regarding recruitment, development of topic guides, interviews and focus groups, and how the findings can be used in clinical practice. Conclusion This research will mean clinicians can offer adults living with FM an online resource to support the delivery of the FSMP in the NHS. Findings from the research will help design a future study testing effectiveness.