2019冠状病毒病大流行期间的痛风管理与结局：一项横断面网络调查
Gout management and outcomes during the COVID-19 pandemic: a cross-sectional internet survey.
作者信息
Singh Jasvinder A, Edwards N Lawrence
机构信息
University of Alabama at Birmingham, Faculty Office Tower 805B, 510 20th Street South, Birmingham, AL 35294, USA.
Department of Medicine, Division of Rheumatology, Immunology and Allergy, University of Florida, Gainesville, FL, USA.
出版信息
Ther Adv Musculoskelet Dis. 2020 Oct 14;12:1759720X20966124. doi: 10.1177/1759720X20966124. eCollection 2020.
AIM
We aimed to assess the gout management during the COVID-19 pandemic.
METHODS
We assessed medication use, healthcare utilization, gout-specific health-related quality of life (HRQoL) on the Gout Impact Scale (GIS), psychological distress using the patient health questionnaire-4 (PHQ-4), and resilience in people with self-reported physician-diagnosed gout during the COVID-19 pandemic in a cross-sectional Internet survey.
RESULTS
Among the 122 survey respondents with physician-diagnosed gout, 82% were prescribed urate-lowering therapy (ULT) and 66% were taking ULT daily; mean age was 54.2 years [standard deviation (SD), 13.8], 65% were male, and 79% were White. More regular use of gout medication was reported during the COVID-19 pandemic: allopurinol, 44%; colchicine, 37%; non-steroidal anti-inflammatory drugs, 36%. Gout flares were common: 63% had ⩾1 gout flare monthly; 11% went to emergency room/urgent care; and 2% were hospitalized with gout flares. Between 41% and 56% of respondents reported more difficulty with gout management and related functional status related to COVID-19; 17-37% had difficulty with healthcare access for gout. HRQOL deficits were evident for gout concern overall, 79.4 (SD, 25); unmet gout treatment need, 64.5 (SD, 27.1); and gout concern during flare, 67.3 (SD, 27.1); but less so for gout medication side effects, 48.9 (SD, 27.4). Psychological distress was moderate in 19% and severe in 15% (mild, 22%; normal, 45%). Resilience score on Connor-Davidson Resilience Scale (CD-RISC2) was 5.6 (SD, 1.8; range 0-8). Compared with no/mild psychological distress, moderate-severe psychological distress during the COVID-19 pandemic was significantly associated with more difficulty getting gout medication filled ( = 0.02), flares treated ( = 0.005), and receiving gout education ( = 0.001).
CONCLUSION
Healthcare gaps, psychological distress, and HRQoL deficits were commonly reported by people with gout during the COVID-19 pandemic. Interventions to address these challenges for people with gout during the COVID-19 pandemic are needed.
目的
我们旨在评估2019冠状病毒病大流行期间痛风的管理情况。
方法
在一项横断面网络调查中，我们评估了2019冠状病毒病大流行期间自我报告有医生诊断痛风的患者的药物使用情况、医疗保健利用情况、痛风影响量表（GIS）上痛风特异性健康相关生活质量（HRQoL）、使用患者健康问卷-4（PHQ-4）评估的心理困扰以及恢复力。
结果
在122名经医生诊断患有痛风的调查受访者中，82%的人接受了降尿酸治疗（ULT），66%的人每天服用ULT；平均年龄为54.2岁[标准差（SD），13.8]，65%为男性，79%为白人。据报告，在2019冠状病毒病大流行期间痛风药物的使用更为规律：别嘌醇，44%；秋水仙碱，37%；非甾体抗炎药，36%。痛风发作很常见：63%的人每月有⩾1次痛风发作；11%的人前往急诊室/紧急护理；2%的人因痛风发作住院。41%至56%的受访者报告在痛风管理及与2019冠状病毒病相关的功能状态方面遇到更多困难；17%至37%的人在获得痛风医疗服务方面有困难。痛风总体关注度、未满足的痛风治疗需求以及痛风发作期间的关注度方面的HRQOL缺陷明显，分别为79.4（SD，25）、64.5（SD，27.1）和67.3（SD，27.1）；但痛风药物副作用方面的缺陷较小，为48.9（SD，27.4）。19%的人心理困扰为中度，15%为重度（轻度，22%；正常，45%）。康纳-戴维森复原力量表（CD-RISC2）的复原力得分为5.6（SD，1.8；范围0-8）。与无/轻度心理困扰相比，2019冠状病毒病大流行期间中度至重度心理困扰与痛风药物配药困难（=0.02）、发作治疗困难（=0.005）以及接受痛风教育困难（=0.001）显著相关。
结论
痛风患者在2019冠状病毒病大流行期间普遍报告了医疗保健差距、心理困扰和HRQoL缺陷。需要采取干预措施来应对2019冠状病毒病大流行期间痛风患者面临的这些挑战。
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