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Gout management and outcomes during the COVID-19 pandemic: a cross-sectional internet survey
Jasvinder A Singh1, N Lawrence Edwards2
1University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street South, Birmingham, AL 35294, USA.
Insights
Gout patients faced challenges in medication adherence and healthcare access during the COVID-19 pandemic, leading to increased flares and distress. Targeted interventions are crucial to improve gout management and quality of life for these individuals.
Area of Science:
- Rheumatology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly disrupted healthcare delivery and patient management for chronic conditions.
- Gout, a common inflammatory arthritis, requires consistent management to prevent flares and long-term complications.
Purpose of the Study:
- To evaluate gout management, including medication use, healthcare access, quality of life, and psychological distress among gout patients during the COVID-19 pandemic.
- To identify challenges faced by individuals with gout during the pandemic and inform necessary interventions.
Main Methods:
- A cross-sectional online survey was conducted among 122 individuals with physician-diagnosed gout.
- Data collected included medication use (urate-lowering therapy - ULT), healthcare utilization, Gout Impact Scale (GIS) for quality of life, Patient Health Questionnaire-4 (PHQ-4) for psychological distress, and resilience.
Main Results:
- 82% of participants were prescribed ULT, with 66% taking it daily. Gout flares were frequent (63% monthly), with some requiring emergency care (11%) or hospitalization (2%).
- Significant difficulties were reported in gout management (41-56%) and healthcare access (17-37%). HRQoL deficits were noted, particularly for unmet treatment needs and gout concern during flares.
- Moderate to severe psychological distress (34%) was associated with increased challenges in medication access, flare management, and receiving gout education.
Conclusions:
- People with gout experienced significant healthcare gaps, psychological distress, and reduced quality of life during the COVID-19 pandemic.
- There is a clear need for interventions to address these challenges and improve the comprehensive management of gout during public health crises.
Aim:
We aimed to assess the gout management during the COVID-19 pandemic.
Methods:
We assessed medication use, healthcare utilization, gout-specific health-related quality of life (HRQoL) on the Gout Impact Scale (GIS), psychological distress using the patient health questionnaire-4 (PHQ-4), and resilience in people with self-reported physician-diagnosed gout during the COVID-19 pandemic in a cross-sectional Internet survey.
Results:
Among the 122 survey respondents with physician-diagnosed gout, 82% were prescribed urate-lowering therapy (ULT) and 66% were taking ULT daily; mean age was 54.2 years [standard deviation (SD), 13.8], 65% were male, and 79% were White. More regular use of gout medication was reported during the COVID-19 pandemic: allopurinol, 44%; colchicine, 37%; non-steroidal anti-inflammatory drugs, 36%. Gout flares were common: 63% had ⩾1 gout flare monthly; 11% went to emergency room/urgent care; and 2% were hospitalized with gout flares. Between 41% and 56% of respondents reported more difficulty with gout management and related functional status related to COVID-19; 17-37% had difficulty with healthcare access for gout. HRQOL deficits were evident for gout concern overall, 79.4 (SD, 25); unmet gout treatment need, 64.5 (SD, 27.1); and gout concern during flare, 67.3 (SD, 27.1); but less so for gout medication side effects, 48.9 (SD, 27.4). Psychological distress was moderate in 19% and severe in 15% (mild, 22%; normal, 45%). Resilience score on Connor-Davidson Resilience Scale (CD-RISC2) was 5.6 (SD, 1.8; range 0-8). Compared with no/mild psychological distress, moderate-severe psychological distress during the COVID-19 pandemic was significantly associated with more difficulty getting gout medication filled (p = 0.02), flares treated (p = 0.005), and receiving gout education (p = 0.001).
Conclusion:
Healthcare gaps, psychological distress, and HRQoL deficits were commonly reported by people with gout during the COVID-19 pandemic. Interventions to address these challenges for people with gout during the COVID-19 pandemic are needed.
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