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Background The current commissioning models of cardiac and pulmonary rehabilitation for single index conditions such as post-revascularisation, and heart failure may not be addressing the complex needs of people living with multiple long-term conditions (MLTC).Aim The overarching aim of the PERFORM research programme is to develop and evaluate a bespoke co-designed exercise and self-management rehabilitation programme (PERFORM) for people with MLTC. This presentation reports the findings of our feasibility trial.Methods A mixed methods two-group randomised controlled feasibility trial conducted across 3 UK sites. 60 adults with MLTC (defined as presence of ≥2 LTC) with at least one known to benefit from exercise therapy, were randomised 2:1 to PERFORM intervention plus usual care or usual care alone (control). The PERFORM intervention consisted of eight-weeks supervised group-based exercise rehabilitation and self-care symptom-based support. Feasibility outcomes included: trial recruitment (percentage of a target of 60 participants recruited within 4.5-months), retention (percentage of participants with complete EQ-5D data at 3-months), and intervention adherence (percentage of intervention group attending ≥60% sessions). Secondary outcome measures of health-related quality of life, exercise capacity, and symptoms were assessed at baseline and 3-month follow-up. A parallel process evaluation assessed acceptability and feasibility from perspectives of participants and intervention delivery teams.Results Target recruitment was met within the timeframe. Participants (57% female, mean age: 62±13 years, BMI: 30.8±8.0 kg/m 2) had a median of 4 LTC (most common: diabetes (41.7%), hypertension (38.3%), and asthma (36.7%)). EQ-5D outcome retention was 76.7% (46/60 participants) and intervention adherence was 72.5% (29/40 participants). Secondary outcomes within the PERFORM group showed a trend towards greater improvements at 3-months compared to the control group (table 1).Abstract O3 Table 1Secondary outcomes at baseline and 3-month follow-up PERFORM (n=40) Usual care (n=20) Baseline 3 -months Baseline 3 -months Between-group difference of change (95% CI ) EQ-5D Utility Index 0.55 (0.34) 0.60 (0.24) 0.54 (0.25) 0.55 (0.30) 0.05 (-0.07, 0.17) ISWT distance, m 294 (186) 334 (226) 404 (154) 309 (231) 65 (-5, 136) FACIT-F 27.9 (1.9) 32.3 (2.2) 26.2 (2.9) 25.3 (3.9) 3.7 (-1.0, 8.4) Dyspnoea-12 8.5 (1.5) 7.0 (1.5) 8.5 (2.1) 9.5 (2.5) -2.0 (-5.5, 1.5) PHQ-9 8.9 (7.0) 7.7 (6.1) 8.7 (6.7) 8.6 (5.4) -0.5 (-3.5, 2.5) GAD-7 6.4 (1.1) 4.8 (0.9) 5.4 (1.2) 5.0 (1.6) -0.9 (-3.7, 1.9) MoCA 24.6 (2.6) 25.4 (2.9) 25.6 (2.5) 27.2 (1.8) 0.1 (-1.3, 1.5) Conclusion Our feasibility study supports progression to our ongoing multicentre RCT across 20 UK sites to assess clinical- and cost-effectiveness of the PERFORM intervention for people living with MLTC.