Health-related quality of life in gout in primary care: Baseline findings from a cohort study

Priyanka Chandratre, Christian Mallen, Jane Richardson, Sara Muller, Samantha Hider, Keith Rome, Milisa Blagojevic-Bucknall, Edward Roddy, Priyanka Chandratre, Christian Mallen, Jane Richardson, Sara Muller, Samantha Hider, Keith Rome, Milisa Blagojevic-Bucknall, Edward Roddy

Abstract

Objectives: To examine gout-related, comorbid, and sociodemographic characteristics associated with generic and disease-specific health-related quality of life (HRQOL) in gout.

Methods: Adults with gout from 20 general practices were mailed a questionnaire containing the Health Assessment Questionnaire-Disability Index (HAQ-DI), Short-Form-36 Physical Function subscale (PF-10), Gout Impact Scale (GIS), and questions about gout-specific, comorbid and sociodemographic characteristics. Variables associated with HRQOL were examined using multivariable linear regression models.

Results: A total of 1184 completed questionnaires were received (response 65.9%). Worse generic and gout-specific HRQOL was associated with frequent gout attacks (≥5 attacks PF-10 β = -4.90, HAQ-DI β = 0.14, GIS subscales β = 8.94, 33.26), current attack (HAQ-DI β = 0.15, GIS β = -1.94, 18.89), oligo/polyarticular attacks (HAQ-DI β = 0.11, GIS β = 0.78, 7.86), body pain (PF-10 β = -10.68, HAQ-DI β = 0.29, GIS β = 2.61, 11.89), anxiety (PF-10 β = -1.81, HAQ-DI β = 0.06, GIS β = 0.38, 1.70), depression (PF-10 β = -1.98, HAQ-DI β = 0.06, GIS 0.42, 1.47) and alcohol non-consumption (PF-10 β = -16.10, HAQ-DI β = 0.45). Gout-specific HRQOL was better in Caucasians than non-Caucasians (GIS β = -13.05, -13.48). Poorer generic HRQOL was associated with diabetes mellitus (PF-10 β = -4.33, HAQ-DI β = 0.14), stroke (PF-10 β = -12.21, HAQ-DI β = 0.37), renal failure (PF-10 β = -9.43, HAQ-DI β = 0.21), myocardial infarction (HAQ-DI β = 0.17), female gender (PF-10 β = -17.26, HAQ-DI β = 0.43), deprivation (PF-10 β = -7.80, HAQ-DI β = 0.19), and body mass index ≥35kg/m2 (PF-10 β = -6.10, HAQ-DI β = 0.21).

Conclusions: HRQOL in gout is impaired by gout-specific, comorbid, and sociodemographic characteristics, highlighting the importance of comorbidity screening and early urate-lowering therapy. Both gout-specific and generic questionnaires identify the impact of disease-specific features on HRQOL but studies focusing on comorbidity should include generic instruments.

Keywords: Comorbidity; Gout; Health related quality of life; Primary care.

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

References

    1. Kuo C.F., Grainge M.J., Mallen C.D., Zhang W., Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Ann Rheum Dis. 2015;74:661–667.
    1. Roddy E., Zhang W., Doherty M. Is gout associated with reduced quality of life? A case–control study. Rheumatology. 2007;46:1441–1444.
    1. Singh J.A., Strand V. Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans. Ann Rheum Dis. 2008;67:1310–1316.
    1. Lee S.J., Hirsch J.D., Terkeltaub R., Khanna D., Singh J.A., Sarkin A. Perceptions of disease and health-related quality of life among patients with gout. Rheumatology. 2009;48:582–586.
    1. Becker M.A., Schumacher H.R., Benjamin K.L., Gorevic P., Greenwald M., Fessel J. Quality of life and disability in patients with treatment-failure gout. J Rheumatol. 2009;36:1041–1048.
    1. Dalbeth N., Petrie K.J., House M., Chong J., Leung W., Chegudi R. Illness perceptions in patients with gout and the relationship with progression of musculoskeletal disability. Arthritis Care Res. 2011;63:1605–1612.
    1. Khanna P., Nuki G., Bardin T., Tausche A.K., Forsythe A., Goren A. Tophi and frequent gout flares are associated with impairments to quality of life, productivity, and increased healthcare resource use: results from a cross-sectional survey. Health Qual Life Outcomes. 2012;10:117.
    1. Alvarez-Nemegyei J., Cen-Piste J.C., Medina-Escobedo M., Villanueva-Jorge S. Factors associated with musculoskeletal disability and chronic renal failure in clinically diagnosed primary gout. J Rheumatol. 2005;32:1923–1927.
    1. Roddy E., Choi H.K. Epidemiology of gout. Rheum Dis Clin N Am. 2014;40:155–175.
    1. Grainger R., Taylor W.J., Dalbeth N., Perez-Ruiz F., Singh J.A., Waltrip R.W. Progress in measurement instruments for acute and chronic gout studies. J Rheumatol. 2009;36:2346–2355.
    1. Guyatt G.H., Feeny D.H., Patrick D.L. Measuring health-related quality of life. Ann Intern Med. 1993;118:622.
    1. Mazur W., Kupiainen H., Pitkaniemi J., Kilpeläinen M., Sintonen H., Lindqvist A. Comparison between the disease-specific Airways Questionnaire 20 and the generic 15D instruments in COPD. Health Qual Life Outcomes. 2011;9:4.
    1. Bruce B., Fries J.F. The Stanford health assessment questionnaire (HAQ): a review of its history, issues, progress, and documentation. J Rheumatol. 2003;30:167.
    1. Ware J.E., Jr., Sherbourne C.D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483.
    1. Hirsch J.D., Lee S.J., Terkeltaub R., Khanna D., Singh J., Sarkin A. Evaluation of an instrument assessing influence of gout on health-related quality of life. J Rheumatol. 2008;35:2406–2414.
    1. Chandratre P., Roddy E., Clarson L., Richardson J., Hider S.L., Mallen C.D. Health-related quality of life in gout: a systematic review. Rheumatology. 2013;52:2031–2040.
    1. Chandratre P., Mallen C., Richardson J., Rome K., Bailey J., Gill R. Prospective observational cohort study of Health Related Quality of Life (HRQOL), chronic foot problems and their determinants in gout: a research protocol. BMC Musculoskeletal Disord. 2012;13:1–7.
    1. NHS Information Authority . NHS Information Authority; Birmingham: 2000. The clinical terms version 3 (The Read Codes)
    1. Lacey R.J., Lewis M., Jordan K., Jinks C., Sim J. Interrater reliability of scoring of pain drawings in a self-report health survey. Spine (Phila Pa 1976) 2005;30:E455–E458.
    1. Spitzer R.L., Kroenke K., Williams J.B.W., Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–1097.
    1. Kroenke K., Spitzer R.L., Williams J. The PHQ-9. J Gen Intern Med. 2001;16:606–613.
    1. WHO Expert Consultation Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–163.
    1. White I.R., Royston P., Wood A.M. Multiple imputation using chained equations: issues and guidance for practice. Stat Med. 2011;30:377–399.
    1. Roddy E., Muller S., Rome K., Chandratre P., Hider S.L., Richardson J. Foot problems in people with gout in primary care: baseline findings from a prospective cohort study. J Foot Ankle Res. 2015;8:31.
    1. Wallace S.L., Robinson H., Masi A.T., Decker J.L., McCarty D.J., Yü T.F. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum. 1977;20:895–900.
    1. Kelm M.K., Criswell H.E., Breese G.R. Ethanol-enhanced GABA release: a focus on G protein-coupled receptors. Brain Res Rev. 2011;65:113–123.
    1. Gordon E.R. The effect of ethanol on the concentration of gamma-aminobutyric acid in the rat brain. Can J Physiol Pharmacol. 1967;45:915–918.
    1. Kim C., Vincent A., Clauw D., Luedtke C.A., Thompson J.M., Schneekloth T.D. Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia. Arthritis Res Ther. 2013;15:R42.
    1. Hirsch J., Terkeltaub R., Khanna D., Singh J., Sarkin A., Shieh M. Gout disease-specific quality of life and the association with gout characteristics. Patient Relat Outcome Meas. 2010;1:1–8.
    1. Dirken-Heukensfeldt K.J., Teunissen T., Van de Lisdonk E., Lagro-Janssen AL. Clinical features of women with gout arthritis. A systematic review. Clin Rheumatol. 2010;29:575–582.
    1. Harrold L.R., Yood R.A., Mikuls T.R., Andrade S.E., Davis J., Fuller J. Sex differences in gout epidemiology: evaluation and treatment. Ann Rheum Dis. 2006;65:1368–1372.
    1. Khanna P.P., Perez-Ruiz F., Maranian P., Khanna D. Long-term therapy for chronic gout results in clinically important improvements in the health-related quality of life: short form-36 is responsive to change in chronic gout. Rheumatology. 2011;50:740–745.
    1. Lindsay K., Gow P., Vanderpyl J., Logo P., Dalbeth N. The experience and impact of living with gout: a study of men with chronic gout using a qualitative grounded theory approach. J Clin Rheumatol. 2011;17:1–6.
    1. Mak A., Tang C.S., Chan M., Cheak A.A., Ho R.C. Damage accrual, cumulative glucocorticoid dose and depression predict anxiety in patients with systemic lupus erythematosus. Clin Rheumatol. 2011;30:795–803.
    1. Ege M.A., Messias E., Krain L., Thapa P.B. Prevalence of depression in chronically ill older adults (NHANES, 2009-10) Am J Geriatr Psychiatry. 2013;21:S63.
    1. Singh J.A., Taylor W.J., Simon L.S., Khanna P.P., Stamp L.K., McQueen F.M. Patient-reported outcomes in chronic gout: a report from OMERACT 10. J Rheumatol. 2011;38:1452–1457.
    1. Sheldon H., Graham C., Pothecary N., Rasul F. Increasing response rates amongst black and minority ethnic and seldom heard groups. Europe: Picker Institute. 2007
    1. Bowling A. Mode of questionnaire administration can have serious effects on data quality. J Public Health. 2005;27:281–291.
    1. Harris C.M., Lloyd D.C., Lewis J. The prevalence and prophylaxis of gout in England. J Clin Epidemiol. 1995;48:1153–1158.
    1. Meier C.R., Jick H. Omeprazole, other antiulcer drugs and newly diagnosed gout. Br J Clin Pharmacol. 1997;44:175–178.
    1. Roddy E., Mallen C.D., Hider S.L., Jordan K.P. Prescription and comorbidity screening following consultation for acute gout in primary care. Rheumatology. 2010;49:105–111.
    1. Porcheret M., Hughes R., Evans D., Jordan K., Whitehurst T., Ogden H. Data quality of general practice electronic health records: the impact of a program of assessments, feedback, and training. J Am Med Inform Assoc. 2004;11:78–86.
    1. Jordan K., Cameron J.S., Snaith M., Zhang W., Doherty M., Seckl J. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology. 2007;46:1372–1374.
    1. Khanna D., Fitzgerald J.D., Khanna P.P., Bae S., Singh M., Neogi T. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res. 2012;64:1431–1446.
    1. Richette P., Doherty M., Pascual E., Barskova V., Becce F., Castañeda-Sanabria J. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76:29–42.

Source: PubMed

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