Gout and comorbidity: a nominal group study of people with gout
1Medicine Service, Birmingham VA Medical Center, Birmingham, AL, USA. Jasvinder.md@gmail.com.
Insights
Gout significantly impacts patients' other health conditions and their treatments. Managing gout involves complex interactions with existing comorbidities and medications, affecting daily life and well-being.
Area of Science:
- Rheumatology
- Qualitative Health Research
- Patient-Centered Outcomes
Background:
- Comorbidities are prevalent in gout patients, yet qualitative insights into their impact are limited.
- Existing research often overlooks the patient perspective on how gout affects co-existing conditions.
Purpose of the Study:
- To qualitatively explore the lived experiences of patients with gout regarding the impact of gout on their comorbidities.
- To understand how gout and its treatment influence the management of other health conditions from the patient's viewpoint.
Main Methods:
- Nine nominal groups were conducted with 45 patients diagnosed with gout.
- Participants discussed and rank-ordered their concerns about gout's effects on other conditions and treatments.
- Data analysis focused on frequently cited and highly ranked patient concerns.
Main Results:
- Patients frequently cited concerns regarding medication interactions between gout treatments and other conditions.
- Worsening of existing comorbidities, including hospitalizations, anxiety, and depression, were highly ranked concerns.
- Impacts on daily life, diet, exercise, and the development of new conditions or misdiagnoses were also significant patient concerns.
Conclusions:
- Gout and its therapeutic interventions significantly affect the management and progression of comorbidities.
- Addressing these patient-identified concerns can inform strategies for improving overall health outcomes in individuals with gout.
Background:
Comorbidities are common in patients with gout, yet qualitative research is lacking. The study objective was to examine the impact of gout on comorbidities.
Methods:
Nine nominal groups were conducted. Patients with gout discussed and rank-ordered their concerns in response to the question, "How does gout or its treatment affect your other conditions and their treatment?"
Results:
Nine nominal groups had 45 gout patients, with mean age 61 years (standard deviation (SD) 10.7) and mean gout duration 14.9 years (SD 12). Of these, 62% were men, 45% African-American, 51% married and 63% were currently using allopurinol. The most frequently cited highly ranked concerns among the nine nominal groups were: (1) interaction of gout medication with medications for other medical conditions (three groups); (2) worsening of other medical comorbidities, including hospitalizations (seven groups); (3) worsening of anxiety and depression (three groups); (4) significant dietary changes for gout that contrasted with diet for other conditions (three groups); (5) new diseases diagnosed due to gout (three groups); (6) irreversible joint damage (three groups); (7) inability to exercise and weight gain (four groups); and (8) gout misdiagnosed as another health condition (three groups). Other domains ranked highly were: (1) impact of gout on daily life and activities, including the ability to work and social activities (six groups); (2) medication side effects, real and perceived (nine groups); (3) weight loss due to gout related to frequent flares (one group); and (4) cost and burden (three groups).
Conclusions:
Gout and the medications used for its treatment have a significant effect on comorbidities and their management. These findings provide insights into potential targets for improving outcomes in patients with gout.
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