RHEUmatic and musculoskeletal conditions: geographical MApping of Prevalence and outcomeS (RHEUMAPS)

Duration: 01 June 2020 - 31 May 2022
Funder: Nuffield Foundation / Versus Arthritis
Chief investigator: Dr Rosemary Hollick
Other investigators from the group: Professor Gary Macfarlane
Other UoA investigators: Professor Corri Black

Rural areas present a significant challenge to delivering timely and equitable healthcare. Currently we don’t understand how MSK is impacted by living rurally. Focusing on Wales and Scotland, this project will link healthcare records to understand the extent of geographical differences in the prevalence and outcomes of those living with MSK conditions, and factors driving such differences. The team will also survey MSK patients in rural and urban areas about their care to make recommendations for policy.

An interactive tool will be developed to allow decision makers to better understand how geographical differences impact on MSK outcomes.

You can read more information about the study here, or under the headings below.


Study information

What is the study about?

This project will investigate the prevalence and outcomes of rheumatic and musculoskeletal disease (RMD) in rural and urban areas.

Why is this research important?

Delays in diagnosis and treatment are associated with poorer outcomes for RMD. Up to a third of the UK population live in rural areas, but most specialist health services are in urban areas. Poor transport infrastructure makes healthcare difficult to access, particularly for those without cars, and rural communities face greater challenges in recruiting and retaining healthcare workers.

Rural populations are older and the average age is increasing faster than in urban areas. Musculoskeletal diseases are the most common cause of disability in the elderly, and negative effects may be compounded for an older rural population by social isolation and lack of carers. In spite of this, the prevalence and outcomes of RMD in rural versus urban areas is largely unquantified.

What are the aims and methods of the study?

The study aims to map the prevalence and outcomes of RMD in rural compared with urban areas in Scotland and Wales. With large rural populations and unique healthcare linkage capabilities, these provide ideal settings to examine geographical differences in RMD outcomes.

Within the National Safe Haven network in Scotland and the Secure Anonymised Information Linkage (SAIL) databank in Wales, primary care datasets will be linked to national datasets collected at the community, GP, ambulatory and hospital level. Primary care data will include health conditions, prescriptions, appointments, referrals, and socioeconomic and lifestyle details relevant to the patient’s health. Secondary care datasets will provide information on hospital inpatient and outpatient records, A&E, mental health, cancer registry and mortality data. Complementary datasets including Census data, WEALTH (Welsh Employment and Linkage to Health) and Health Wise Wales will also enable the team to explore wider determinants of health.

Finally, to identify the key priorities in diagnosis, treatment and healthcare access for rural RMD patients, the researchers will undertake a priority-setting survey, informed by a series of focus groups with patients from across the UK. In conjunction with Rheumatosphere we will hold a series of stakeholder engagement events to present study fundings, gather feedback and disseminate key study recommendations.

Our patient and professional partners will continue to play an integral role at all stages of the study and engage in a number of different ways to ensure outputs and recommendations are relevant to key stakeholders.

What will the study achieve?

Using the information gathered will be able to conduct a longitudinal analysis of healthcare journeys and outcomes across a wide range of RMD conditions to produce a geographical profile of prevalence and outcomes. This will allow us to produce an interactive digital geographical map of RMD across Scotland and Wales, showing prevalence, health outcomes and patterns of healthcare use across a range of conditions. It will identify the priorities of patients with RMD conditions living in rural areas, as well as the priorities of healthcare professionals involved in their care. These findings will be used to develop recommendations to inform UK healthcare policy.

How can I get involved?

Do you have a rheumatic condition, look after someone with a rheumatic condition or have a relative who is affected? We are looking for members of the public who live in rural locations to help us with our research.

If you would like to get involved, please read and complete the 'Expression of Interest' form below, and return it to:


Study team

Chief investigator


Information for participants

Participant information documentation will be uploaded here shortly.

Contact details

If you have any questions or comments about the study please contact Dr Rosemary Hollick at the following address: