In line with current guidance on the development of interventions, 7 our aim was to develop an intervention that was informed by the existing literature, and refined using qualitative methods (see Figure 1 ).

The first version of the intervention combining PROMs and VCEs was called 'PRISMS' (Patient Report Informing Self-Management Support - see Figure 1 ).

Having developed a first version of the intervention (see Figure 1 ), based on evidence from the literature, the aim of this study was to further develop and evaluate the intervention to enhance patient participation in their health care (see Figure 2 ).

The content of the PRISMS form used in the interviews is represented in Figure 1 , however, as a result of the focus groups, the wording was simplified and the font size increased (Figure 3 ).