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Patients and providers view gout differently: a qualitative study
Leslie R Harrold1, Kathleen M Mazor, Sarah Velten
1Department of Medicine, University of Massachusetts Medical School, Meyers Primary Care Institute and Fallon Clinic, Worcester, USA. leslie.harrold@umassmed.edu
Chronic Illness
|August 3, 2010
Summary
Gout management is suboptimal because providers underestimate patient challenges. Patients report medication ineffectiveness and purposeful non-adherence due to clinical or financial concerns, despite provider confidence.
Area of Science:
- Rheumatology
- Patient-Reported Outcomes
- Health Services Research
Background:
- Gout management is often suboptimal, leading to significant patient burden.
- Understanding patient and provider perspectives is crucial for improving gout care.
Purpose of the Study:
- To investigate patient and provider views on gout treatment.
- To identify reasons for suboptimal gout management.
Main Methods:
- Qualitative study involving in-depth telephone interviews with gout patients (n=26) and healthcare providers (n=15).
- Interviews explored acute and chronic gout management, prevention, and improvement strategies.
- Verbatim transcripts were analyzed using qualitative methods to identify key themes.
Main Results:
- Providers perceived high patient satisfaction with acute treatments (NSAIDs, colchicine, glucocorticoids), contrasting with patient reports of ineffectiveness.
- Discrepancies existed regarding urate-lowering drug (ULD) understanding and response, with some patients experiencing adverse effects or no benefit.
- Patients reported purposeful medication discontinuation due to clinical or financial issues, contrary to provider perceptions of good adherence.
Conclusions:
- A significant gap exists between provider perceptions of gout manageability and patient experiences.
- Patient-reported challenges, including medication efficacy and adherence barriers, contribute to suboptimal gout treatment outcomes.
- Enhanced patient education and longer consultation times are desired by patients to improve self-management.
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