Stefan Elbers

224 Summary remember that the contrasts are calculated with summary statistics and that favourable mean changes in cohorts still leave room for individual patients to relapse. Future studies should provide more insight into the maintenance of treatment gains at the individual patient level. For the second objective, we identified substantial variation between studies in patient inclusion criteria, treatment content, dosing parameters and outcome measures. This not only indicates the existence of different views on optimal designs for IMPT programmes but also hinders meaningful comparisons of these programmes. A crucial challenge for systematic reviewers is keeping up with the increasing speed of publication of primary studies. To prevent our systematic review quickly going out of date, we developed a workflow for a living systematic review (LSR). This type of study is characterized by recurring updates and (semi-)automated procedures to speed up the review process. Although LSRs have been successfully implemented in rapidly developing research areas, we believe there is also potential for iteratively building an up-to-date evidence base in rehabilitation science. In Chapter 3 , we outline this idea and explain the required steps to transform an existing systematic review into a living systematic review. The second aim of this research project was to co-design an intervention with stakeholders that facilitates the maintenance of treatment gains over time. In Chapters 4-7 , we address the following questions: • What are the immediate and long-term effects of generic self-management interventions for patients with chronic musculoskeletal pain in terms of physical functioning, self-efficacy, pain intensity and physical activity? • Which programme characteristics, components, and behaviour change techniques are included in the self-management interventions? • To what extent do co-design practices facilitate the translation of meaningful stakeholder experiences into the design of a health care intervention? • How can co-design contribute to stakeholder involvement, generation of relevant insights and ideas, and incorporation of stakeholder input in the design of an intervention? • How do patients and health care providers evaluate the current workbook prototype in the context of IMPT programmes in terms of acceptability and applicability? • How can we evaluate the effectiveness of the AGRIPPA mHealth intervention, determine its cost-effectiveness, and acquire insight into its level of engagement and usability? This section starts with a systematic review and meta-analysis of generic self- management interventions for patients with chronic musculoskeletal pain (Chapter 4) .