Do Hyunsue, Son Chang-Nam, Choi Hyo Jin, Kim Ji Hyoun, Kim Min Jung, Shin Kichul, Kim Sang-Hyon, Choi Byoongyong, Ha You-Jung, Ahn Joong Kyong, Kim Hyun-Ok, Lee Sung Won, Lee Chang Hoon, Song Ran, Son Kyeong Min, Lee Seung-Geun, Moon Ki Won
Division of Rheumatology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Eulji University School of Medicine, Uijeongbu, Gyeonggi-do, Republic of Korea.
PLoS One. 2025 Feb 7;20(2):e0318564. doi: 10.1371/journal.pone.0318564. eCollection 2025.
Gout, a common form of inflammatory arthritis, is often managed with urate-lowering therapy, but many patients only adhere to treatment during gout attacks, resulting in poor follow-up and suboptimal management. This study aimed to identify characteristics associated with loss to follow-up (LTFU) and develop strategies for better patient management.
Data were analyzed from the Urate Lowering TheRApy in gout (ULTRA) registry, a prospective cohort of Korean gout patients recruited since September 2021. Patients aged 18 or older who met the 2015 ACR/EULAR classification criteria were included. Demographic data, clinical characteristics, lifestyle habits, comorbidities, and quality of life assessments using the Korean Gout Impact Scale (K-GIS) and EuroQol 5-Dimension (EQ-5D) were collected at baseline, six months, and annually. LTFU was defined as missing a clinic visit for more than a year. Logistic regression was used to determine factors associated with LTFU.
Among 269 patients, 125 (46.5%) were classified as LTFU. Patients not lost to follow-up experienced more frequent gout attacks (P = 0.020) and expressed greater concerns about future flares (P = 0.034). In contrast, LTFU patients had higher levels of anxiety (P = 0.049), depressive symptoms (P = 0.009), impaired mobility (P = 0.002), and a higher EQ-5D score (P = 0.002). Logistic regression identified frequent gout attacks, concerns about attacks, anxiety, impaired mobility, and EQ-5D scores as significant predictors of LTFU.
Fewer gout attacks, heightened anxiety and depression, and lower quality of life were key factors associated with LTFU. Providing emotional support and comprehensive education may enhance follow-up and improve gout management.
痛风是炎症性关节炎的常见形式，通常采用降尿酸治疗，但许多患者仅在痛风发作时坚持治疗，导致随访不佳和管理不理想。本研究旨在确定与失访（LTFU）相关的特征，并制定改善患者管理的策略。
对痛风降尿酸治疗（ULTRA）登记处的数据进行分析，该登记处是自2021年9月起招募的韩国痛风患者的前瞻性队列。纳入符合2015年美国风湿病学会/欧洲抗风湿病联盟分类标准的18岁及以上患者。在基线、6个月和每年收集人口统计学数据、临床特征、生活习惯、合并症以及使用韩国痛风影响量表（K-GIS）和欧洲五维健康量表（EQ-5D）进行的生活质量评估。LTFU定义为错过门诊就诊超过一年。采用逻辑回归确定与LTFU相关的因素。
在269例患者中，125例（46.5%）被归类为LTFU。未失访的患者痛风发作更频繁（P = 0.020），对未来发作表示出更大的担忧（P = 0.034）。相比之下，LTFU患者焦虑水平更高（P = 0.049）、有抑郁症状（P = 0.009）、行动能力受损（P = 0.002）且EQ-5D评分更高（P = 0.002）。逻辑回归确定痛风发作频繁、对发作的担忧、焦虑、行动能力受损和EQ-5D评分是LTFU的重要预测因素。
痛风发作较少、焦虑和抑郁加剧以及生活质量较低是与LTFU相关的关键因素。提供情感支持和全面教育可能会加强随访并改善痛风管理。
