Abstract
Aim We sought to examine patients’ knowledge and beliefs concerning gout and its treatment in order to identify ways to improve gout care.
Methods We identified all members (>18 years of age) of a group-model health maintenance organization (HMO) with documentation of at least one health care encounter associated with a gout diagnosis during the period 2008–2009 (n=1346). From this population a random sample of 500 subjects were sent a questionnaire assessing knowledge with regard to gout, beliefs about prescription medications used to treat gout, satisfaction with physician-patient communication, and trust in the physician.
Results Two hundred and forty patients returned surveys and research authorization forms (response rate of 51%). The majority of patients were male (80%), white (94%), and aged 65 and older (66%). Only 14 (6%) patients were cared for by a rheumatologist. Many participants were unaware of foods that may lead to a gout flare. Specifically, more patients reported vegetables (58%), chicken (55%) and legumes (39%) as triggers as compared to seafood (23%), beef (22%) and pork (7%). Only 43% reported beer could increase the chances of a gout flare. Awareness of dietary triggers was not greater among those with more encounters for gout or chronic gout (identified by use of urate-lowering drugs [ULDs]). For the management of acute flares, nonsteroidal anti-inflammatory drugs were considered easy to take (86%) and effective in decreasing pain (78%) with only 22% having side effects to the agents. Among colchicine users, colchicine was considered easy to take (91%) and effective (76%) but 37% reported side effects to the medication. There were 101 patients prescribed a ULD of whom 21% reported forgetting to take their medication in the past month. Only a minority of ULD users (12%) were aware of the risk of flare when initiating treatment with this medication class.
Conclusion In this gout patient population cared for mostly by primary care providers, we identified several knowledge deficits that may worsen disease management including lack of knowledge regarding dietary triggers and lack of awareness of the risk of gout flare with initiation of ULDs.
