Our study provides information on patient knowledge and perceptions
regarding gout management. Several deficits in knowledge were identified
in the study sample, including in the quality assessment of knowledge
about gout, information about gout, and demographic
information.11 However, the deficits were greater in
those with uncontrolled gout. Thirty-one percent of patients reported
having uncontrolled gout, and 69% of patients reported having
controlled gout. Males were more likely than females to be affected by
uncontrolled gout. This result was consistent with the study by Richette
et al. (2018) in France; with a 62-item questionnaire and 246 patients,
the study also showed that gout status had no association with
gender.12 In our study, age had a significant
association with gout status: there were more cases of gout as age
increased; this result contradicts those of the study by Richette et al.
(2018). In another study by Gaffo (2018) and the Global Health Living
Foundation in Jordan (with a sample of 103 patients, 41 with flare-ups
and 62 without flare-ups), it was shown that the incidence of gout among
the patients was associated with age.13 Nationality
had no association with gout status in our study. However, educational
status was significantly associated with gout status, as patients with
bachelor’s degrees had the highest incidence of gout compared with
others.14Job status was significantly associated with gout status. Patients with
full-time employment were more susceptible to gout than retirees, those
with part-time jobs, or students without jobs. Physicians and patient
height were not significantly associated with gout status. BMI had a
significant association with gout status in this sample, with a high BMI
being a risk factor and a low BMI being protective.
Several factors may contribute to the patient knowledge deficits and the
incorrect medication beliefs identified here.15 Most
of the patients had been diagnosed with gout less than 3 years before
completing the survey, and duration of disease was associated with gout
status. Patients with longer intervals since diagnosis were less
susceptible to gout flare-ups compared with those who had more recent
diagnoses. The majority of patients had been diagnosed with gout between
the ages of 25 and 64 years. Patients who had been diagnosed between 25
years and 64 years of age were less susceptible to gout flare-ups
compared with those diagnosed outside of this interval. The majority of
patients had three to six gouty attacks per year, but the frequency of
such attacks had no association with the patients’ gout statuses at the
time of survey completion. Most patients had
one to two gouty attacks per year, and this status had a significant
association with the patients’ gout statuses at the time of survey
completion. We found that knowledge and medical beliefs had significant
impacts on gout status.
For the treatment of acute gout, there are individualizable treatment
strategies. Paracetamol, ibuprofen, and colchicine are considered among
the most effective drugs to treat gout attacks; it is also important to
increase fluid intake. There was a significant association between
patients’ knowledge about drugs for treating gout attacks and their gout
status. Overall, patients in the study sample considered all of
the well-established lifestyle measures to control their gout. Patients
with controlled gout considered a reduction of meat and bean consumption
as the second-line lifestyle measure to control gout, while patients
with uncontrolled gout considered exercise and weight loss as the
second-line lifestyle measures. Notably, there was no significant
association between patients’ implemented lifestyle measures in treating
gout and their gout statuses.16In the quality-of-life assessment, patients were very satisfied in terms
of their job performance, work lives and careers, daily demands and
chores, health services, sleep quality, and support from family and
friends. There was a significant association between the patients’
quality-of-life assessments related to gout and their gout statuses. The
opposite was found in a study conducted in
Australia,17 which demonstrated gout to have a
significant impact on patients’ lives; the findings suggested that the
patients’ primary concerns were poor mobility and the pain associated
with gout flare-ups. The study report also covered the social impacts of
gout and its negative effects on productivity.
Our study indicated different ways by which patients manage their gout:
46% of patients sought advice from a nutritionist, 90.1% spoke with
doctors about minimizing the consumption of foods that contain high
levels of uric acid (such as meat and legumes), and 62.4% spoke with
their doctors about how to treat acute gout attacks. About
three-quarters of patients (77.9%) spoke with their doctors about
medications that can lower uric acid levels in the blood and how to
prevent gout attacks, and 85% of the patients spoke with their doctors
about the ideal levels of uric acid in their blood that should be
achieved after treatment for gout. Nearly three-quarters of participants
(74.2%) spoke with their doctors about adopting healthy lifestyle
choices, such as eating moderate amounts of red meat, legumes, and
shrimp to reduce the levels of uric acid in their blood (in addition to
taking medication), and 50% of the patients spoke with their doctors
about smoking
cessation to manage acute gout. Management perceptions were
significantly associated with gout status.