Background/Purpose:  Gout is a chronic disease caused by deposition of monosodium urate crystals.  Although diet is a risk factor, many other factors also contribute to development of gout, including age, male sex, kidney disease and genetic variants.  Historical and contemporary narratives frequently depict gout as an acute condition caused by dietary overindulgence.  These perceptions of illness may have a negative impact on healthcare-seeking and management strategies. The aim of this study was to examine the effect of changing the disease label of gout on the perceptions of the illness and its management.   

Methods: Supermarket shopper participants were recruited into this study (n=189).  Participants were advised that the aim of the study was to examine the perceptions of different types of arthritis. Participants were randomised to read an identical description of an illness labelled as either gout or urate crystal arthritis (UCA), and complete a questionnaire examining their perception of the illness, likely causal factors, and the usefulness of various management strategies.  The label urate crystal arthritis was selected to represent the core pathophysiological elements of disease, including urate as the causative biochemical substrate, crystal deposition, and joint inflammation.   Differences between the two illness labels were tested using independent sample t-tests.

Results: The gout-labelled illness was attributed more to patient behaviour (p = 0.030) through poor diet (p = 0.013) and overconsumption of alcohol (p = 0.039), while the UCA- labelled illness was attributed more to aging (p = 0.006).  There were no differences in beliefs about other causal factors.  The gout-labelled illness was viewed as under more personal control (p = 0.001) and as more socially embarrassing (p < 0.001), whereas the UCA- labelled illness was viewed as having a more chronic timeline (p = 0.044) and as a more serious condition (p = 0.037).  Changing to a healthier diet was perceived as more helpful for the gout-labelled illness (p = 0.014).  In contrast, taking long-term medications for the condition was viewed as more helpful for the UCA-labelled illness (p = 0.041).  There was no significant difference between the illness labels in perceptions that reducing stress, adopting regular exercise, losing weight or using alternative medicine would be helpful for managing the illness (p for all >0.08).

Conclusion: The negative cultural stereotypes surrounding the disease label gout may be a barrier to effective treatment.  Changing the name of the illness from gout to a pathophysiological illness label such urate crystal arthritis may have a positive benefits for patient understanding of the condition and the adoption of effective management strategies.