Background/Purpose: To assess gout management during the COVID-19 pandemic since September 2020.

Methods: We assessed urate-lowering therapy (ULT) use, healthcare utilization, gout-specific health-related quality of life (HRQOL; 0-100 range; higher scores = lower/pooper HRQOL), health literacy, illness perception, psychological distress using patient health questionnaire-4 (2 questions each for depression and anxiety; 0-6 each), and resilience using on Connor-Davidson Resilience Scale (CD-RISC2; range 0-8; higher=more resilient) scale in people with self-reported physician-diagnosed gout in a cross-sectional Internet survey.

Results: Among the 121 survey respondents with self-reported physician-diagnosed gout, 60% were prescribed urate-lowering therapy (ULT) and 33% were taking ULT daily since September 2020. The mean age of respondents was 62.8 years (standard deviation [SD], 12.6), 65% were male, and 82% were White. Regular daily use of gout medications was reported during the COVID-19 pandemic since September 2020 as follows: allopurinol, 31%; febuxostat, 4%; probenecid, 2%; colchicine, 7%; NSAIDs, 9%; glucocorticoids, 4%. Gout flares were common, i.e., 76% reported ≥1 gout flare. Overall, 29% of respondents reported more difficulty with managing their gout since September 2020.

Gout-specific HRQOL deficits were evident for all scales: (1) gout concern overall, 72.9 (SD, 25); (2) unmet gout treatment need, 54.2 (SD, 24.7); (3) gout concern during flare, 55.5 (SD, 24.5); (4) gout well-being during flare, 55.4 (SD, 23.6); and (5) gout medication side effects, 56.5 (SD, 25.5).

Psychological distress was moderate in 10% and severe in 14% (mild, 27%; none/normal, 50%). Resilience score was 6.5 (SD, 1.9). Health literacy was high with mean score of 18.5 (SD, 2.5; range 4-20).

Adjusted for age, and sex, compared to no depression or anxiety, depression with PHQ-2 score ≥3, and anxiety with PHQ-2 score of ≥3, were significantly associated with: (1) difficulty with getting healthcare for gout in clinic, emergency room or urgent care, and in-hospital; (2) difficulty getting gout flares treated, avoiding gout flares, and avoiding complications from gout; and (4) difficulty with daily activities, and performing work; and depression, but not anxiety with regular ULT use (Table 1).

Conclusion: Respondents with gout reported healthcare gaps, psychological distress, illness perception and HRQOL deficits since September 2020 during the COVID-19 pandemic. Anxiety and depression were associated with poorer ULT adherence and more difficulty managing gout. Interventions to address psychological comorbidity in gout are needed during the COVID-19 pandemic.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/gout-management-and-outcomes-during-the-covid-19-pandemic-in-late-2020-2021-a-cross-sectional-internet-survey/