Patient Perceptions of Gout Management Goals

A Cross-Sectional Internet Survey

Jasvinder A. Singh, MBBS, MPH; N. Lawrence Edwards, MD

Disclosures

J Clin Rheumatol. 2020;26(4):129-133. 

In This Article

Results

Of the 454 visitors to the website who clicked on the survey, 320 survey respondents reported physician-diagnosed gout, with a mean age of 57 (SD, 13.4) years, 72% male, 77% White and 10% were Hispanic or Latino (Table 1). Mean (SD) gout duration and gout flares in the last year were 7.6 years (11) and 5.2 (6.1), respectively. The total number of medical comorbidities including gout was 2.7 (2.6); 42% had three or more comorbidities.

Of these, 66% had ≥2 gout flares, and 84% had ≥1 gout flare in the last year. Only 10% reported mild or no symptoms of gout, with two-thirds reporting very severe or severe symptoms from gout; 85% were worried that their gout will get worse over time. Gout ranked among the top two health conditions with a negative impact on quality of life in two-thirds of the respondents.

During a clinic visit, only one-third of respondents' physicians spent 50% of more of the time discussing gout treatment, <50% participants were extremely or very satisfied with the gout care from their regular doctor and one-third each did not talk about symptoms of gout or the importance of monitoring serum urate level for gout treatment during the doctor's visit (Table 2). In contrast, only 54% were prescribed ULT by their healthcare provider, and of these, 72% reported a ULT adherence of ≥80%.

The best life-long gout treatment strategies in the order of preference were the lowering of the serum urate level and the control of gout symptoms (62%) followed by serum urate lowering (32%) followed by treatment of gout symptoms (2%) and no treatment (3%) (Table 2). No significant differences in gout treatment goals by sex, race or age were noted (data not shown).

Respondent perception of the most important things that could make their gout treatment most successful and satisfactory mapped to a few key constructs (Supplementary File 1, http://links.lww.com/RHU/A138): (1) patient education; (2) effective physician–patient communication; (3) diet and lifestyle modification recommendations; (4) serum urate level monitoring; (5) pain management and flare prevention; and (6) medication and overall management, including prescription refills and minimization of medication side effects.

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