The MSKCOM study

The impact of musculoskeletal conditions on outcomes of other illnesses: a linked electronic health record study

Chief Investigator: Professor Kelvin Jordan
Principal Investigators: Dr Michelle Marshall
Funder name / reference number: Nuffield Foundation; Oliver Bird Fund (OBF/21967)
Year: 2020-2022

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The project has been funded by the Nuffield Foundation, but the views expressed are those of the authors and not necessarily the Foundation. Visit

This project explores whether having musculoskeletal conditions leads to worse outcomes for other illnesses.

Previous research has shown that a large proportion of people with musculoskeletal pain have other coexisting long-term conditions. When a patient has multiple conditions, healthcare professionals often do not consider the management of musculoskeletal pain to be a priority. However, pain and associated reduced mobility and sleep interference may adversely impact the effectiveness of any treatment and may be a factor in prolonged hospital stay.

The study will use information collected from a large UK database of general practice records (the Clinical Practice Research Datalink), which contains high-quality information from over 40 million patients in 1491 UK general practices covering about 20% of the UK population. Data linkages include inpatient hospital records (Hospital Episode Statistics). neighbourhood deprivation, and mortality data (Office for National Statistics). We will analyse data of patients newly diagnosed with: i) recorded acute coronary syndrome or stroke; ii) dementia; iii) breast, prostate, lung and colorectal cancer; and iv) pneumonia. These illnesses have major impacts on quality of life and are of high priority for the NHS. We will determine whether having musculoskeletal pain leads to earlier and longer hospital stays, worse outcomes such as death and faster progression of illness, and differences in management. We will assess if the impact of musculoskeletal pain on these illnesses is different for people of different age or ethnicity, or who live in different areas of the country, or in a deprived area.

If we find there is a link of musculoskeletal pain with poor outcomes, this will provide new evidence of the need to test better musculoskeletal management strategies before and during hospital admission (for example, exercise/physiotherapy, aids/devices for daily living, and better drug treatment) to reduce pain and improve function, that may improve outcomes across other illnesses.


Conference abstracts:

  • Musculoskeletal pain and its impact on prognosis following hospitalisation for acute coronary syndrome or cerebrovascular accident: a linked electronic health record cohort study (MSKCOM). Mason KJ, Jordan KP, Achana F , Bailey J , Chen Y , Frisher M , Heron N, Huntley AL , Mallen CD, Mamas MA, Marshall M, Png ME , Tatton S, White S , Edwards JJ. Society for Academic Primary Care North Conference 2021 - oral presentation
  • Musculoskeletal pain and prognosis for acute coronary syndrome and cerebrovascular accident: a linked electronic health record cohort study. Mason KJ, Jordan KP, Achana F, Bailey J, Chen Y, Frisher M, Herron N, Huntley AL, Mallen CD, Mamas MA, Marshall M, Png ME , Tatton S, White S, Edwards JJ. British Society of Rheumatology Annual Conference 2022 - Poster presentation
  • Impact of musculoskeletal pain on outcome of comorbidities: the MSKCOM study. KP Jordan, KJ Mason, FA Achana, J Bailey, Y Chen, M Frisher, N Heron, AL Huntley, CD Mallen, MA Mamas, ME Png, S Tatton, S White, JJ Edwards, M Marshall. National Musculoskeletal Health Data Group (Versus Arthritis) 2022 - Oral presentation. 
  • Musculoskeletal pain and its impact on rates of hospitalisation and mortality in cancer: a linked electronic health record cohort study (MSKCOM). Mason KJ , Bailey J, Heron N, Marshall M, Achana F, Chen Y, Edwards JJ, Frisher M, Huntley AL, Mallen CD, Mamas MA, Png ME, Tatton S, White S, Jordan KP. Society for Academic Primary care Annual Scientific Meeting 2022 - Oral Presentation.