Health-related Quality of Life in Gout in Primary Care: Baseline Findings From a Cohort Study
Chandratre, P; Mallen, C; Richardson, J; Muller, S; Rome, K; Blagojevic-Bucknall, M; Roddy, E
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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 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 to 33.26), current attack (HAQ-DI β=0.15, GIS β=−1.94 to 18.89), oligo/polyarticular attacks (HAQ-DI β=0.11, GIS β=0.78 to 7.86), body pain (PF-10 β=−10.68, HAQ-DI β=0.29, GIS β=2.61 to 11.89), anxiety (PF-10 β=−1.81, HAQ-DI β=0.06, GIS β=0.38 to 1.70), depression (PF-10 β=−1.98, HAQ-DI β=0.06, GIS 0.42 to 1.47) and alcohol non-consumption (PF-10 β=−16.10, HAQ-DI β=0.45, GIS β=4.94). 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≥35 kg/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.