From the Medicine Service, Birmingham VA Medical Center, Birmingham, AL.
Department of Medicine at School of Medicine, and Division of Epidemiology at School of Public Health, University of Alabama, Birmingham, AL.
J Clin Rheumatol. 2020 Jun;26(4):129-133. doi: 10.1097/RHU.0000000000000981.
To assess patient perceptions of gout management goals.
We conducted a cross-sectional Internet survey of people who visited the Gout and Uric Acid Education Society's website to assess patient/respondent perception of gout management goals. We used chi-square test for categorical or t-test for continuous variables.
Among the 320 survey respondents with physician-diagnosed gout, mean age was 57 (SD, 13.4) years, 72% were male, 77% White; mean gout duration was 7.6 years (SD, 11), gout flares in the last year were 5.2 (SD, 6.1), and medical comorbidities were common, 2.7 (SD, 2.6). Two-thirds respondents each reported very severe or severe symptoms from gout and that gout ranked among the top two health conditions with a negative impact on quality of life. During a clinic visit, only one-third of respondents' physicians spent 50% of more of the time discussing gout treatment. Only 54% respondents were prescribed ULT by their healthcare provider. By patient preference, the best life-long gout treatment strategies were the lowering of the serum urate level and the control of gout symptoms (62%) followed by serum urate lowering (32%). Respondents considered the following as the most important things for making gout treatment satisfactory: (1) patient education; (2) effective physician-patient communication; (3) diet and lifestyle modification; (4) serum urate monitoring and target achievement; (5) pain management and flare prevention; and (6) medication management.
Patient identification of gout symptom control and serum urate level monitoring as the most important treatment goals is informative for clinicians and guideline developers.
评估患者对痛风管理目标的认知。
我们通过痛风和尿酸教育协会网站对患者/受访者进行了一项横断面互联网调查，以评估患者/受访者对痛风管理目标的认知。我们使用卡方检验进行分类变量分析，使用 t 检验进行连续变量分析。
在 320 名经医生诊断患有痛风的调查受访者中，平均年龄为 57（标准差 13.4）岁，72%为男性，77%为白人；痛风平均病程为 7.6 年（标准差 11），过去一年中有 5.2 次（标准差 6.1）痛风发作，且合并症常见，为 2.7（标准差 2.6）种。三分之二的受访者报告痛风症状非常严重或严重，且痛风是对生活质量有负面影响的前两种健康状况之一。在就诊期间，只有三分之一的受访者的医生有超过 50%的时间用于讨论痛风治疗。只有 54%的受访者接受了他们的医疗保健提供者的 ULT 处方。根据患者的偏好，最佳的终身痛风治疗策略是降低血清尿酸水平和控制痛风症状（62%），其次是降低血清尿酸（32%）。受访者认为以下几点是使痛风治疗令人满意的最重要因素：（1）患者教育；（2）有效的医患沟通；（3）饮食和生活方式的改变；（4）血清尿酸监测和目标达成；（5）疼痛管理和痛风发作预防；以及（6）药物管理。
患者将控制痛风症状和监测血清尿酸水平作为最重要的治疗目标，这为临床医生和指南制定者提供了信息。
