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Foot problems in people with gout in primary care: baseline findings from a prospective cohort study
Edward Roddy1, Sara Muller1, Keith Rome2
1Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK.
Insights
Foot problems like hallux valgus and pain are common in gout patients, often leading to healthcare visits. Obesity and gout characteristics are associated with foot pain and disability, highlighting the need for targeted patient assessment and treatment.
Area of Science:
- Rheumatology
- Podiatry
- Public Health
Background:
- Foot problems are prevalent in individuals with gout.
- The healthcare burden of these foot issues remains largely unquantified.
- Understanding prevalence and associations is crucial for healthcare planning.
Purpose of the Study:
- To determine the prevalence of hallux valgus, foot pain, and disability in gout patients.
- To identify factors associated with these foot problems.
- To assess the frequency of healthcare consultations for foot issues in this population.
Main Methods:
- Cross-sectional study involving 1,184 gout patients via mailed questionnaires.
- Validated instruments used to assess hallux valgus, foot pain, and disability.
- Logistic regression analyzed associations with demographic, comorbidity, and gout-specific factors.
Main Results:
- Prevalence: Hallux valgus (36.3%), foot pain (22.3%), disabling foot pain (14.5%).
- Hallux valgus associated with age and female gender.
- Foot pain linked to age, obesity, depression, and polyarticular gout.
- Disabling foot pain associated with age, obesity, depression, and ischemic heart disease.
- 42.8% consulted GPs and 23.7% consulted podiatrists for foot problems.
Conclusions:
- Foot problems are common and frequently lead to healthcare consultations in gout patients.
- Hallux valgus associations mirror the general population.
- Foot pain and disability are linked to obesity, gout characteristics, and comorbidities.
- Clinical assessment should include foot problems for relevant treatment.
Background:
Foot problems are common in people with gout yet the prevalence of current foot problems in people with gout and the burden they present to healthcare systems is not known. This cross-sectional study aimed to determine the prevalence and associations of hallux valgus, foot pain and disability in people with gout, and to assess the frequency with which foot problems lead to consultation with healthcare professionals.
Methods:
Adults registered with 20 general practices who had consulted their GP about gout or been prescribed allopurinol or colchicine in the preceding two years were mailed a questionnaire. Prevalence of hallux valgus, foot pain in the last month, and disabling foot pain in the mailed population were ascertained using validated instruments and estimated by inverse-weighted logistic regression. Associations with socio-demographic, comorbid and gout-specific factors were examined using logistic regression. Participants were asked if they had seen health care professionals for foot problems within the preceding 12 months.
Results:
One thousand one hundred eighty-four questionnaires were received (response 66 %). Prevalence of hallux valgus was 36.3 %, foot pain in the last month 22.3 % and disabling foot pain 14.5 %. Hallux valgus associated with age (adjusted OR 1.47 per 10-year increase, 95 % CI 1.26, 1.72) and female gender (2.03; 1.31, 3.15). Foot pain in the last month associated with age (1.24; 1.00, 1.55), obesity (BMI 30.0-34.9 2.67; 1.32, 5.38; BMI ≥ 35.0 3.16; 1.44, 6.93), mild depression (2.04; 1.09, 3.81) and polyarticular gout attacks (1.86; 1.18, 2.95). Disabling foot pain associated with age (1.42; 1.08, 1.87), obesity (BMI 30.0-34.9 3.73; 1.54, 9.09; BMI ≥ 35.0 4.36; 1.64, 11.64), depression (mild 2.63; 1.25, 5.53; moderate 3.53; 1.11, 11.26) and ischaemic heart disease (2.45; 1.32, 4.53). In the previous 12 months, 495 (42.8 %) reported consulting their GP about their feet and 281 (23.7 %) a podiatrist/chiropodist.
Conclusions:
Foot problems are common in people with gout and frequently lead to healthcare consultation. Hallux valgus has similar associations to those seen in the general population, whereas foot pain associates with obesity and gout characteristics, and disabling foot pain with obesity and comorbidity. Patient assessment should consider foot problems and offer specific treatment where relevant.
