General Practice and Primary Care

Our study seeks to explore the presence and experience of multimorbidity (having two or more long term conditions) in people with persistent musculoskeletal pain and explore how the presence of a number of health conditions affects people’s capacity to manage. As musculoskeletal pain incorporates a wide range of conditions, we will also study these issues in more detail in people with rheumatoid arthritis (RA), the commonest and best studied inflammatory arthritis.

We will undertake three pieces of related work to look at the general experience of people with persistent musculoskeletal pain as well as those with RA. The first two pieces of work involve statistical analysis of two existing sets of data (UK Biobank and the Scottish Early Rheumatoid Arthritis (SERA) cohorts) to examine what and how many conditions people with persistent musculoskeletal pain or RA have and how this impacts on quality of life and health-related outcomes such as mortality and hospitalisations; we will also explore whether patient factors like deprivation and age have an effect on the results.

The third piece of work involves interviewing people living with persistent musculoskeletal pain or RA and HCPs to explore their experiences of living with and managing persistent musculoskeletal pain or RA and multimorbidity. We are particularly interested in the "treatment burden" otherwise known as the workload of self-management that people experience and what influences their capacity to deal with any given level of treatment burden. 

Our findings will help us to develop new ways of managing and tailoring treatments for people living with persistent musculoskeletal pain or RA and multimorbidity that will minimise their level of treatment burden and maximise their capacity to self-manage.

We have created two animations to summarise the findings from the MAP study.

The first considers the experience of two participants in our qualitative work package, where we spoke to people living with rheumatoid arthritis or chronic pain and additional long-term conditions.

Video 1

The second animation summarises the findings from our data analysis work into health-related outcomes for people living with rheumatoid arthritis or chronic pain and additional long-term conditions.

Video 2

Principal investigator

• Dr Barbara Nicholl University of Glasgow @BarbNicholl

Co-investigators

• Professor Frances Mair University of Glasgow @FrancesMair
• Dr Sara Macdonald University of Glasgow
• Dr Bhautesh Jani University of Glasgow @BhauteshJani
• Professor Colin McCowan, University of St Andrews
• Dr Stefan Siebert University of Glasgow @StefanSiebert1

Researchers

• Dr Susan Browne University of Glasgow
• Dr Yvonne Cunningham University of Glasgow
• Karen Wood, University of Glasgow
• Dr Guy Rughani University of Glasgow

Students

• Jordan Canning, University of Glasgow

Administrative support

• Ms Karen Penman University of Glasgow

• Morton, F. R. , Jani, B. D. , Mair, F. S. , McLoone, P. , Canning, J., Macdonald, S. , McQueenie, R., Siebert, S.  and Nicholl, B. I.  (2023) Association between risk, duration and cause of hospitalisations in people with rheumatoid arthritis and multimorbidity in the UK Biobank and Scottish Early Rheumatoid Arthritis (SERA) cohorts: longitudinal observational study. Seminars in Arthritis and Rheumatism, 58, 152130. doi: 10.1016/j.semarthrit.2022.152130
• McLoone P, Jani BD, Siebert S, et al. Classification of long-term condition patterns in rheumatoid arthritis and associations with adverse health events: a UK Biobank cohort study. Journal of Multimorbidity and Comorbidity. 2023;13. doi:10.1177/26335565221148616
• Hastie, Claire E.; Foster, Hamish M.E.; Jani, Bhautesh D.; O'Donnell, Catherine A.; Ho, Frederick K.; Pell, Jill P.; Sattar, Naveed; Katikireddi, Srinivasa V.; Mair, Frances S.; Nicholl, Barbara I. Chronic pain and COVID-19 hospitalisation and mortality: a UK Biobank cohort study. PAIN 164(1):p 84-90, January 2023. doi:10.1097/j.pain.0000000000002663
• McQueenie R, Jani BD, Siebert S, et al. Prevalence of chronic pain in LTCs and multimorbidity: A cross-sectional study using UK Biobank. Journal of Multimorbidity and Comorbidity. 2021;11. doi:10.1177/26335565211005870
• McQueenie R, Nicholl BI, Jani BD, et al Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants BMJ Open 2020;10:e038829. doi:10.1136/bmjopen-2020-038829

• Qualitative approach by Yvonne Cunningham
• Multimorbidity by Bhautesh Jani
• Persistent pain by Barbara Nicholl
• Treatment burden by Frances Mair

Susan Browne susan.browne@glasgow.ac.uk