Racial differences in health-related quality of life and functional ability in patients with gout
Jasvinder A Singh1,2,3,4, Aseem Bharat2,3, Dinesh Khanna5
1Medicine Service, Birmingham VA Medical Center Jasvinder.md@gmail.com.
Insights
African Americans with gout experience worse health-related quality of life (HRQOL) compared to Caucasians. Targeted research is needed to improve outcomes for African Americans with gout.
Area of Science:
- Rheumatology
- Health Services Research
- Health Disparities
Background:
- Gout is a common inflammatory arthritis.
- Health-related quality of life (HRQOL) and functional ability are key outcomes in gout management.
- Racial disparities in health outcomes are well-documented across various conditions.
Purpose of the Study:
- To compare health-related quality of life (HRQOL) and functional ability between Caucasian and African American patients with gout.
- To identify potential racial differences in the impact of gout on patients' lives.
Main Methods:
- A 9-month prospective, multicenter cohort study was conducted.
- Patients with gout self-reported race (Caucasian or African American).
- HRQOL and functional ability were assessed using the Short Form-36 (SF-36), Gout Impact Scale (GIS), and HAQ-disability index (HAQ-DI), with scores adjusted for covariates using multivariable mixed-effect regression models.
Main Results:
- African American patients with gout were younger and had higher serum urate levels compared to Caucasian patients.
- African Americans reported significantly worse HRQOL scores on several SF-36 domains, the mental component summary (MCS), and two GIS scales.
- No statistically significant differences were found in the HAQ-disability index (HAQ-DI) scores between racial groups, although differences approached minimal clinically important thresholds.
Conclusions:
- African Americans with gout experience significantly worse HRQOL compared to Caucasians.
- These findings highlight racial disparities in the patient experience of gout.
- Further research focused on African American populations is warranted to develop targeted interventions to improve outcomes.
Objective:
To compare the health-related quality of life (HRQOL) and the functional ability by race in patients with gout.
Methods:
In a 9-month prospective cohort multicentre study, patients with gout self-reported race, dichotomized as Caucasian or African American (others excluded). We calculated HRQOL/function scores adjusted for age, study site and college education for Short Form-36 (SF-36; generic HRQOL), Gout Impact Scale (GIS; disease-specific HRQOL) and HAQ-disability index (HAQ-DI; functional ability). Longitudinally adjusted scores were computed using multivariable mixed-effect regression models with a random patient effect and fixed sequential visit effect (3-monthly visits).
Results:
Compared with Caucasians (n = 107), African Americans (n = 60) with gout were younger (61.1 vs 67.3 years) and had higher median baseline serum urate (9.0 vs 7.9 mg/dl) (P < 0.01). African Americans with gout had worse HRQOL scores on three SF-36 domains, the mental component summary (MCS) and two of the five GIS scales than Caucasians [mean (se); P ⩽ 0.02 for all]: SF-36 mental health, 39.7 (1.1) vs 45.2 (0.9); SF-36 role emotional, 42.1 (4.2) vs 51.4 (4.2); SF-36 social functioning, 36.0 (1.1) vs 40.0 (0.9) (P = 0.04); SF-36 MCS, 43.2 (3.1) vs 50.0 (3.2); GIS unmet treatment need, 37.6 (1.6) vs 31.5 (1.4); and GIS concern during attacks, 53.3 (3.7) vs 47.4 (3.7). Differences between the respective HAQ-DI total scores were not statistically significant; 0.98 (0.1) vs 0.80 (1.0) (P = 0.11). Racial differences in SF-36 mental health, role emotional and MCS scales exceeded, and for HAQ-DI approached, the minimal clinically important difference thresholds.
Conclusions:
African Americans with gout have significantly worse HRQOL compared with Caucasians. Further research is necessary in the form of studies targeted at African Americans on how best to improve these outcomes.
Related Concept Videos
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
01:25Drug Dosing in Renal Diseases: Measurement of Glomerular Filtration Rate
01:08Effect of Hepatic Disease on Pharmacokinetics: Dose Adjustments Due to Hepatic Impairment