Medicine Service, Birmingham VA Medical Center, Birmingham, AL, USA.
Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama, Birmingham, AL, USA.
Clin Rheumatol. 2018 Sep;37(9):2557-2566. doi: 10.1007/s10067-018-4243-7. Epub 2018 Aug 4.
To assess the goals of gout treatment from a patient perspective, a convenience sample of consecutive patients with doctor-diagnosed gout seen at a community-based outpatient clinic were invited. Sex-stratified nominal groups were conducted until saturation was achieved. Responses were collected verbatim, discussed, and rank-ordered by each participant. Thirty-six patients with doctor-diagnosed gout participated in 12 nominal groups: 6 male only, 5 female only, and 1 group with both. Mean age was 61.9 years (SD, 12.3); mean gout duration was 13.3 years (SD, 12.5); 53% were men, 64% African-American, 42% retired, 47% currently married, 87% were using either allopurinol and/or febuxostat, and 40% had had no gout flares in the last 6 months. The top 5 treatment goals accounted for 91% of all votes and included the following: (1) prevent and better manage flare-ups and improve function (25%), (2) eliminate flare-ups/disease remission (30%), (3) diet and activity modification/lifestyle change (13%), (4) patient education and public awareness (12%), and (5) medication management and minimization of side effects (11%). When examining the top-rated concern for each nominal group, the first two goals were nominated by four groups each, diet/activity modification and medication management by 1 group each, and patient education by 3 groups. There were no differences evident by sex in top-ranked treatment goal. People with gout identified and rank-ordered treatment goals relevant to them. Providers of gout care need to be cognizant of these goals. Disease management concordant with these treatment goals might lead to a more satisfied, informed patient.
为了从患者角度评估痛风治疗的目标，我们邀请了在社区门诊就诊的经医生诊断患有痛风的连续患者进行方便样本的便利抽样。进行了性别分层的名义小组讨论，直到达到饱和为止。参与者逐字记录、讨论和排序了回复。36 名经医生诊断患有痛风的患者参加了 12 个名义小组：6 个仅为男性，5 个仅为女性，1 个为男女混合组。平均年龄为 61.9 岁（标准差，12.3）；平均痛风持续时间为 13.3 年（标准差，12.5）；53%为男性，64%为非裔美国人，42%退休，47%已婚，87%正在使用别嘌醇和/或非布司他，40%在过去 6 个月内没有痛风发作。前 5 名治疗目标占所有选票的 91%，包括以下内容：（1）预防和更好地管理发作和改善功能（25%），（2）消除发作/疾病缓解（30%），（3）饮食和活动改变/生活方式改变（13%），（4）患者教育和公众意识（12%），以及（5）药物管理和最小化副作用（11%）。在检查每个名义小组的首选关注时，前两个目标由四个小组各提名一次，饮食/活动改变和药物管理各由一个小组提名一次，患者教育由三个小组提名。按性别划分，顶级治疗目标没有明显差异。痛风患者确定并对相关治疗目标进行了排序。痛风护理提供者需要意识到这些目标。与这些治疗目标一致的疾病管理可能会使患者更满意、更知情。
