Gender differences in illness perceptions and disease management in patients with gout, results from a questionnaire study in Western Sweden

Abstract

Background Aims were to examine gender differences in patients with gout with regard to a) self-reported gout severity, b) illness perceptions (IP), c) impact on daily activities and Quality of Life (QoL), d) advice from healthcare professionals, e) having changed dietary- or alcohol habits. Methods Adult patients with gout identified in primary and secondary care in Sweden between 2015 and 2017 (n = 1589) were sent a questionnaire about demographics, gout disease severity, IP (using the Brief Illness Perception Questionnaire, (B-IPQ)) and disease management. T-tests, Chi square tests, ANalysis Of VAriance (ANOVA) and linear regression models were used for gender comparisons. Results Eight hundred sixty-eight patients responded to the questionnaire. Women, n = 177 (20%), experienced more severe gout symptoms (p = 0.011), albeit similar frequencies of flares compared to men. Women experienced modest but significantly worse IP with regard to consequences, identity, concerns and emotional response (p < 0.05) as well as daily activities such as sleeping (p < 0.001) and walking (p = 0.042) and QoL (p = 0.004). Despite this and a higher frequency of obesity in women (38 vs 21%, P < 0.001) and alcohol consumption in men (p < 0.001), obese women had received significantly less advice regarding weight reduction (47 vs 65%, p = 0.041) compared to obese men. On the other hand, women reported having acted on dietary advice to a larger degree. Conclusions Despite only modestly worse gout severity and perception, women appear to have been given less information regarding self-management than men. These gender differences should be given attention and addressed in clinical care.

The Evolving Landscape of Gout in the Female: A Narrative Review

“…Therefore, postmenopausal gout patients with osteoporosis might benefit from treat-to-target ULT. In a recent questionnaire-based study that addressed illness perception of gout according to sex, females felt more disabled, and their pain scores were higher in acute gout flares [156]. Furthermore, allopurinol hypersensitivity syndrome incidence is higher in female gout patients, which may be partially related to a larger CKD population [157,158].…”

The Evolving Landscape of Gout in the Female: A Narrative Review

“…Therefore, postmenopausal gout patients with osteoporosis might benefit from treat-to-target ULT. In a recent questionnaire-based study that addressed illness perception on gout according to sex, women felt more disabled and pain score was higher in acute gout flares [165]. Furthermore, allopurinol hypersensitivity syndrome incidence is higher in female gout patients, which may be partially related to a greater CKD population [166,167].…”

Sex-Specific Differences in Cytokine Production Capacity in Patients with Gout Compared to Controls

“…Still, clinical profiles of patients with gout are reported to differ by sex: older age, higher prevalence of comorbidities, use of diuretics have been reported more in women [4], and high consumption of alcohol, especially beer, in men [5]. Women report greater disease severity, which affects their daily activities, despite their better adherence to dietary modifications and receiving the same treatment as men [5,6]. These differences could result in bias in clinical care since a study shows that women receive medical advice for disease management less often than men [6].…”

“…Women report greater disease severity, which affects their daily activities, despite their better adherence to dietary modifications and receiving the same treatment as men [5,6]. These differences could result in bias in clinical care since a study shows that women receive medical advice for disease management less often than men [6].…”