Abstract
BackgroundGout is the commonest inflammatory arthritis affecting around 1.4% of adults in Europe. It is predominantly managed in primary care and classically affects the joints of the foot, particularly the first metatarsophalangeal joint. Gout related factors (including disease characteristics and treatment) as well as comorbid chronic disease are associated with poor Health Related Quality of Life (HRQOL) yet to date there is limited evidence concerning gout in a community setting. Existing epidemiological studies are limited by their cross-sectional design, selection of secondary care patients with atypical disease and the use of generic tools to measure HRQOL. This 3 year primary care-based prospective observational cohort study will describe the spectrum of HRQOL in community dwelling patients with gout, associated factors, predictors of poor outcome, and prevalence and incidence of foot problems in gout patients.MethodsAdults aged ≥ 18 years diagnosed with gout or prescribed colchicine or allopurinol in the preceding 2 years will be identified through Read codes and mailed a series of self-completion postal questionnaires over a 3-year period. Consenting participants will have their general practice medical records reviewed.DiscussionThis is the first prospective cohort study of HRQOL in patients with gout in primary care in the UK. The combination of survey data and medical record review will allow an in-depth understanding of factors that are associated with and lead to poor HRQOL and foot problems in gout. Identification of these factors will improve the management of this prevalent, yet under-treated, condition in primary care.
Highlights
Gout is the commonest inflammatory arthritis affecting around 1.4% of adults in Europe
Cross-sectional epidemiological studies in primary care have shown that gout has an independent association with impaired Health Related Quality of Life (HRQOL), affecting the physical domain, after adjustments for co-morbidities such as osteoarthritis, renal and cardiovascular disease [6,7]
A limitation of the study is the identification of patients based on a clinical diagnosis of gout
Summary
Gout is the commonest inflammatory arthritis affecting around 1.4% of adults in Europe. Existing epidemiological studies are limited by their cross-sectional design, selection of secondary care patients with atypical disease and the use of generic tools to measure HRQOL. This 3 year primary care-based prospective observational cohort study will describe the spectrum of HRQOL in community dwelling patients with gout, associated factors, predictors of poor outcome, and prevalence and incidence of foot problems in gout patients. A recent qualitative study [9] on the impact of gout highlighted the lack of understanding and the stigma associated with this condition which often leads to under-reporting of symptoms This in turn can lead to suboptimal treatment despite disease severity
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