title: Self-management programmes in temporomandibular disorders: results from an international Delphi process.
abstract: Self-management (SM) programmes are commonly used for initial treatment of patients with temporomandibular disorders (TMD). The programmes described in the literature, however, vary widely with no consistency in terminology used, components of care or their definitions. The aims of this study were therefore to construct an operationalised definition of self-management appropriate for the treatment of patients with TMD, identify the components of that self-management currently being used and create sufficiently clear and non-overlapping standardised definitions for each of those components. A four-round Delphi process with eleven international experts in the field of TMD was conducted to achieve these aims. In the first round, the participants agreed upon six principal concepts of self-management. In the remaining three rounds, consensus was achieved upon the definition and the six components of self-management. The main components identified and agreed upon by the participants to constitute the core of a SM programme for TMD were as follows: education; jaw exercises; massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. This Delphi process has established the principal concepts of self-management, and a standardised definition has been agreed with the following components for use in clinical practice: education; self-exercise; self-massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. The consensus-derived concepts, definitions and components of SM offer a starting point for further research to advance the evidence base for, and clinical utility of, TMD SM.
authors.affiliation: Centre for Oral Health Research & Institute of Health and Society, Newcastle-upon-Tyne Hospitals' NHS Foundation Trust, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: J
authors.initials: J
authors.lastname: Durham
authors.affiliation: Oral Surgery Unit, Al-Noor Specialized Dental Care Centre, Iraqi Ministry of Health, Baghdad, Iraq.
authors.forename: M
authors.initials: M
authors.lastname: Al-Baghdadi
authors.affiliation: Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Baad-Hansen
authors.affiliation: Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: M
authors.initials: M
authors.lastname: Breckons
authors.affiliation: Faculty of Dental Medicine, Université Laval, Quebec, QC, Canada.
authors.forename: J P
authors.initials: JP
authors.lastname: Goulet
authors.affiliation: Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam (ACTA), MOVE Research Institute Amsterdam, University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Lobbezoo
authors.affiliation: Department of Orofacial Pain and Jaw Function, Scandinavian Center for Orofacial Neurosciences (SCON), Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: List
authors.affiliation: Section of Orthodontics, Department of Neuroscience, Reproductive and Oral Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Michelotti
authors.affiliation: Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Nixdorf
authors.affiliation: Faculty of Dentistry, The University of Sydney, Sydney, NSW, Australia.
authors.forename: C C
authors.initials: CC
authors.lastname: Peck
authors.affiliation: New York University College of Dentistry, New York, NY, USA.
authors.forename: K
authors.initials: K
authors.lastname: Raphael
authors.affiliation: Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
authors.forename: E
authors.initials: E
authors.lastname: Schiffman
authors.affiliation: Centre for Oral Health Research & Institute of Health and Society, Newcastle-upon-Tyne Hospitals' NHS Foundation Trust, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: J G
authors.initials: JG
authors.lastname: Steele
authors.affiliation: Centre for Oral Health Research, Newcastle University, Newcastle-upon-Tyne, UK.
authors.forename: W
authors.initials: W
authors.lastname: Story
authors.affiliation: Department of Oral Diagnostic Sciences, School of Dental Medicine, University at Buffalo, Buffalo, NY, USA.
authors.forename: R
authors.identifier: http://orcid.org/0000-0002-9266-9734
authors.initials: R
authors.lastname: Ohrbach
mesh_terms: D032921:Consensus; D003697:Delphi Technique; D005081:Exercise Therapy; D005157:Facial Pain / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D010353:Patient Education as Topic; D012648:Self Care / Q000379:methods; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000628:therapy*
keywords: Delphi process; Delphi technique; conservative management; self-care; self-management; temporomandibular disorders; temporomandibular joint disorders