We are pleased to share that the results of the MOBILIZE randomized controlled trial (RCT) have now been published in Nature Medicine. This large, pragmatic trial provides new and much-needed evidence on the effectiveness of a personalized exercise therapy and self-management support program for people living with multimorbidity.

Why MOBILIZE matters

Multimorbidity - defined as the co-occurrence of two or more long-term conditions—affects over one-third of the adult population globally, often emerging earlier in disadvantaged communities. Despite its high prevalence and growing burden on patients and healthcare systems, there remains a lack of robust evidence on effective, scalable management strategies.

The EU-funded MOBILIZE project (European Research Council, grant agreement No 801790) directly addresses this evidence gap by evaluating an intervention specifically focusing on person-centered care, exercise therapy, and self-management support.

This blog is a follow-up of a blog published last year, where you will be able to find further details on the MOBILIZE project.

Study design and participants

MOBILIZE was a multicentre, assessor-blinded RCT conducted in Denmark, enrolling 228 adults with two or more selected long-term conditions including osteoarthritis, chronic obstructive pulmonary disease, heart disease, hypertension, type 2 diabetes, and depression. Participants were randomized to receive either:

  • A 12-week personalized exercise and self-management program in addition to usual care, or
  • Usual care alone.

Importantly, the intervention was designed through a collaborative development process involving patients, carers, clinicians, and researchers, ensuring its relevance and feasibility.

Key findings

  • Health-Related Quality of Life (HRQoL): At 12 months, the intervention group had a statistically significant greater improvement in HRQoL (primary outcome) compared to usual care alone (EQ-5D-5L adjusted mean difference: 0.064; 95% CI: 0.014–0.115).
  • Self-Rated Health: The intervention group also reported a greater improvement in EQ-VAS (mean difference: 6.9 points; 95% CI: 1.8–12.1).
  • Other Secondary outcomes: Both groups reported a statistically significant improvement in the 30 second chair-stand test, while only the intervention group improved in the 6-minute walk test, Bayliss burden of illness measure, Personal Health Questionnaire Depression Scale, World Health Organization Disability Assessment Schedule.
  • Safety: There was no increase in serious adverse events (SAEs) compared to the usual care group; 36 and 48 SAEs in the exercise therapy and self-management group and usual care group, respectively (P = 0.388). 

The clinical significance of these findings remains a key point for further exploration - especially considering the broad heterogeneity in this patient group and the lack of between-group differences in most secondary outcomes.

Context in the evidence base

Previous systematic reviews, including recent a Cochrane systematic review, have identified limited evidence for effective interventions in multimorbidity. The MOBILIZE trial, one of the largest and most carefully conducted studies in this area, differs from earlier well conducted research like the 3D trial, which did not show improvements in HRQoL.

Moreover, the benefits in secondary outcomes like depression, functional performance, and disability—though not statistically significant between groups—provide encouraging signals supporting the wider potential of behavior-based, non-pharmacological interventions even in people with multimorbidity.

Next steps

Future work from the MOBILIZE team will explore long-term sustainability, cost-effectiveness, and biological mechanisms, alongside planned analyses of physical activity, treatment burden and other patient-reported outcomes.

In the meantime, this publication adds important support to the growing consensus that multimorbidity management must move beyond condition-specific silos and towards integrated, behaviorally-informed models of care.

Please also share our publication with colleagues and network to ensure that it reaches as many relevant people as possible.

Potential to collaborate

We invite researchers from around the world who are interested in utilizing the MOBILIZE data for specific research purposes to contact us. For a full list of outcomes see our protocol paper.

Contact us

For further information on the MOBILIZE project, please contact:

Søren Thorgaard Skou, Principal investigator, Professor, Physiotherapist, PhD

Næstved-Slagelse-Ringsted Hospitals and University of Southern Denmark

Tel: +4523708640

Email: stskou@health.sdu.dk

First published: 22 July 2025

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