Multimorbidity in Arthritis and persistent musculoskeletal Pain (MAP) Study: protocol for a mixed methods study

Conference:

SAPC ASM 2019 - Exeter

Talk Code:

P2.28

Presenter:

Ross McQueenie

Twitter:

@RossMcqueenie

Co-authors:

Sara Macdonald 1, Ross McQueenie 1, Joanne Neary 1, Bhautesh Jani 1, Stefan Siebert 2, Colin McCowan 3, Frances Mair 1, Barbara Nicholl 1

Author institutions:

1 General Practice and Primary Care, University of Glasgow, 2 Institute of Infection, Immunity & Inflammation, University of Glasgow, 3 School of Medicine, University of St Andrews

Problem

Multimorbidity, the presence of ≥2 long term conditions (LTCs), is an urgent healthcare challenge. Painful arthritis-related conditions are long-term in nature and often experienced alongside other LTCs. We know people with multimorbidity experience increased levels of “work” or treatment burden when managing their LTCs.However, we know relatively little about the impact of multimorbidity on people living with persistent musculoskeletal (MSK) pain and arthritis in terms of effects on: healthcare experiences; health related quality of life; general wellbeing; and health-related outcomes. It is unclear how the presence of multimorbidity in those with persistent MSK pain and arthritis influences healthcare professional (HCP) management approaches.

Approach

Aim: To explore the issue of persistent MSK pain and rheumatoid arthritis (RA) together with multimorbidity. Our work addresses nine research questions using three connected work packages (WPs). WP11. What pattern of multimorbidity (number and type of LTCs) do people with persistent MSK pain report? 2. How does multimorbidity affect the overall health of people with persistent MSK pain? 3. Do the pattern of multimorbidity and its effects differ between those with persistent MSK pain and non-musculoskeletal pain?We will use UK Biobank (cohort > 500,000) to answer these questions.WP24. What pattern of multimorbidity (number and type of LTCs) do people with RA have? 5. How does multimorbidity affect the overall health of people with RA? 6. Do the patterns of multimorbidity (number and type of LTCs) differ in people with persistent musculoskeletal pain compared to those with RA? 7. Is there a difference in the effect of multimorbidity on the overall health of people with persistent musculoskeletal pain compared to those with RA?We will use both UK Biobank and The Scottish Early Rheumatoid Arthritis (SERA) cohort (a group of approximately 1000 patients with newly diagnosed RA recruited from rheumatology clinics across Scotland) to answer these questions. WP38. What are HCPs experiences of treating and managing patients with persistent musculoskeletal pain or RA and multimorbidity? 9. How does multimorbidity affect self-management and the capacity to cope in those living with persistent MSK pain or RA?We will use qualitative methods to answer these questions: interviews with 40 HCPs and interviews with 80 people living with persistent MSK pain or RA with and without multimorbidity.

Findings

This 30 month study started in November 2018. First findings from WP1 and WP2 will be available from March 2019 and from WP3 in September 2019.

Consequences

In the final phase of work we will run workshops with HCPs, patients, and policy-makers to decide how to use our findings to design interventions to increase capacity to manage persistent MSK pain or RA in the context of multimorbidity.

Submitted by:

Susan Browne

Funding acknowledgement:

FUNDING: VERSUS ARTHRITIS Grant Referent: 21970