Background/Purpose:

The increasing global burden of gout disease and its impact on the patient’s quality of life calls for new strategies in management. Even though gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases due in part to barriers in patient knowledge and perception about the disease. Our aim was to assess the disease-related knowledge and attitude among gout patients in inpatient setting and to identify the barriers to optimal management.

Methods:

A cross section survey of patients admitted to a community hospital for various reasons including acute gout flare from March 2016 through March 2017 was conducted using a 10-item gout related survey, previously used in the literature. Patients were identified for survey if they carried a diagnosis for gout based on American college of rheumatology classification criteria. Patient medication and demographic information was also collected. Patients were considered to have “good” knowledge if they answered 70% of the questions correctly. Gout survey performance was compared to demographic and medication data. In bivariate analysis, we examined differences in mean survey performance using 1-way analysis of variance (ANOVA). We obtained adjusted relative risks (RRs) of good knowledge by estimating a multivariable Poisson regression model with robust variance estimates, adjusted for covariates. Analyses were conducted using Stata, version 14.2.

Results:

Fifty-eight patients surveys were conducted. Most were aged 65 and older (60%) with equal number of males and females. Only 29% of respondents completed college or above and 24% were currently employed. Mean duration of gout in years was 11.8 years. Thirty-nine (81%) patients had at least one visit to the treating physician and thirty-five patients had at least 1 flare (60%) in last year. Most of the patients were taking allopurinol (69%). Good knowledge was demonstrated by 60% of the respondents. Knowledge strengths in terms of percentage of patients having correct answers included the majority of patients identifying that gout was related to elevated uric acid levels (86%); that pain with swelling in the joint as being a sign of acute flare (82%); and that hypertension was associated with gout (89%). Knowledge gaps included: uric acid goals (19%), treatment of acute flare (29%), prophylaxis of flare (37%), duration of ULT (42%), and life style modification (14%). In multivariable regression analysis, gout related knowledge was found to be higher among females (RR-1.5; P=0.03; 95% CI,1.04 to 2.28); patients with higher level of education (RR-3.4; P=0.04;95% CI,1.08 to 10.9) and in those patients using allopurinol (RR-1.9; P=0.05; 95% CI,0.97 to 4.00).

Conclusion:

We conclude that a large disease related knowledge gap is identified in our survey of gout patients in inpatient setting. Our data informed the areas of major knowledge gaps. We also identified certain demographic and medication factors influencing gout knowledge. To our knowledge this is the first patient education study in gout focusing on a hospitalized patient population, and we believe the inpatient setting may be a focus of opportunity for gout education.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/survey-on-gout-related-knowledge-and-perception-in-inpatient-setting-on-hospitalized-patients-with-gout/