Racial differences in health-related quality of life and functional ability in patients with gout

Abstract

Objective. To compare the health-related quality of life (HRQOL) and the functional ability by race in patients with gout.Methods. In a 9-month prospective cohort multicentre study, patients with gout self-reported race, dichotomized as Caucasian or African American (others excluded). We calculated HRQOL/function scores adjusted for age, study site and college education for Short Form-36 (SF-36; generic HRQOL), Gout Impact Scale (GIS; disease-specific HRQOL) and HAQ-disability index (HAQ-DI; functional ability). Longitudinally adjusted scores were computed using multivariable mixed-effect regression models with a random patient effect and fixed sequential visit effect (3-monthly visits).Results. Compared with Caucasians (n = 107), African Americans (n = 60) with gout were younger (61.1 vs 67.3 years) and had higher median baseline serum urate (9.0 vs 7.9 mg/dl) (P < 0.01). African Americans with gout had worse HRQOL scores on three SF-36 domains, the mental component summary (MCS) and two of the five GIS scales than Caucasians [mean (S.E.); P 4 0.02 for all]: SF-36 mental health, 39.7 (1.1) vs 45.2 (0.9); SF-36 role emotional, 42.1 (4.2) vs 51.4 (4.2); SF-36 social functioning, 36.0 (1.1) vs 40.0 (0.9) (P = 0.04); SF-36 MCS, 43.2 (3.1) vs 50.0 (3.2); GIS unmet treatment need, 37.6 (1.6) vs 31.5 (1.4); and GIS concern during attacks, 53.3 (3.7) vs 47.4 (3.7). Differences between the respective HAQ-DI total scores were not statistically significant; 0.98 (0.1) vs 0.80 (1.0) (P = 0.11). Racial differences in SF-36 mental health, role emotional and MCS scales exceeded, and for HAQ-DI approached, the minimal clinically important difference thresholds.Conclusions. African Americans with gout have significantly worse HRQOL compared with Caucasians. Further research is necessary in the form of studies targeted at African Americans on how best to improve these outcomes.

Associated factors with functional disability and health-related quality of life in Chinese patients with gout: a case-control study

“…Existing studies have documented that demographic and clinical variables have an impact on functional disability and HRQoL in individuals with gout [ 10 , 11 , 33 ]. Similar to the results of Chandratre et al, the data in the present study showed that DM has a substantial impact on HAQ-DI.…”

“…Previous studies have revealed that gout individuals had impaired overall HRQoL compared with general population [ 8 , 9 ]. It has been reported that socioeconomic status and disease-related characteristics may have an impact on functional disability and HRQoL in subjects with gout [ 8 , 10 , 11 ]. Current evidence estimated that gout patients affected by severe pain, tophi, polyarticular disease, a great number of attacks, and more number of involved joints frequently had functional disability and worse HRQoL [ 11 – 13 ].…”

Use of the Gout Impact Scale to Evaluate Quality of Life in Chinese Subjects with Gout: A Cross-Sectional Study

“…Gout is a painful, inflammatory form of arthritis, caused by abnormal metabolism of purines and the resulting accumulation of uric acid crystals within the joints and other tissues [ 1 , 2 ]. Estimates indicate that 1 to 3% of the Chinese population has gout [ 3 ], with the incidence rate gradually increasing [ 4 , 5 ]. Individuals with gout experience severe gout flares, chronic recurrent pain, and joint swelling, resulting in a reduction in their quality of life (QoL) [ 6 , 7 ], which is poorer in individuals with gout than in physically and mentally healthy persons [ 8 ].…”

Low medication adherence is associated with decline in health-related quality of life: results of a longitudinal analysis among older women and men with hypertension

“…n = 400 in the fully adjusted model testing the association between low K-Wood-MAS-4 adherence and decline in PCS). Race differences in adherence [ 36 ] and HRQOL [ 37 ] warrant further research with larger subgroup samples.…”