Results of a consensus process to determine the elements of a complex digital intervention for distal upper limb musculoskeletal disorders

Abstract Background/Aims Painful distal upper limb (DUL) musculoskeletal disorders (MSDs), including hand, wrist and elbow problems, are common but lack effective self-management tools. The Digital-My Arm Pain Programme (D-MAPP) aims to develop and test a digital self-management intervention for DUL-MSDs. This project aimed to determine the elements required for the D-MAPP intervention package. Methods A review of self-management interventions for DUL-MSDs identified 31 potential intervention elements. Subsequently, the elements were grouped into three overarching categories; Information and self-management advice, Information on treatment options, and Features of an exercise programme. Next, we employed Delphi methodology to develop consensus on the intervention elements from key stakeholders: Healthcare professionals who manage DUL-MSDs and people with a DUL-MSD (pwDUL-MSDs). A three-round modified online/postal Delphi questionnaire was used, with collation and presentation of results in subsequent rounds. Participants scored the importance of including each element in the D-MAPP intervention using a 9-point Likert scale; 1-3 limited importance, 4-6 important but not critical, 7-9 critical. Consensus was pre-defined as > 70% of both healthcare professionals and pwDUL MSDs scoring an element in the same category. During each round, participants could suggest additional intervention elements for inclusion in the subsequent round. Results 23 healthcare professionals from a range of disciplines (including occupational therapists, physiotherapists, rheumatologists and orthopaedic surgeons) and 19 pwDUL-MSD completed round one; 83% and 89%, respectively, completed all three rounds. Round 1, consensus was achieved for 24 of the 31 elements, which were all deemed as critical to include in the D-MAPP intervention (Table 1). Two elements were suggested by participants and added to round 2. Two additional elements reached consensus as being critical in Round 2, and one further element reached consensus for inclusion in the third round. Six potential intervention elements did not reach a consensus. Conclusion Healthcare professionals and patients reached consensus on 27 elements, all of which were deemed as critical to include in the D-MAPP intervention. However, agreement among stakeholders on the importance level was not achieved for six potential elements. Following this work, the critically important elements will be developed through a co-design process to build the D-MAPP digital intervention. L. Brading: None. K. Kane: None. G. McHugh: None. K. Dziedzic: None. J. Adams: None. S. Chopra: None. L. Swaithes: None. K. Walker-Bone: None. G. Macfarlane: None. P. Conaghan: None. S. Kingsbury: None.