New study evaluates how disease and its treatments affect other common conditions
by Gregory M. Weiss MD, Rheumatology Network November 11, 2017

Gout and the medications used for its treatment worsen the comorbidities as well as patients’ perceptions of their quality of life.
Gout leads many patients to report feeling a sense of “body failure” and to have a negative effect on social roles. Also, a loss of identity-associated performance is progressive in patients with gout.
The most common inflammatory arthritis, gout has been linked to obesity and the metabolic syndrome as well as to associated comorbidities, such as heart disease, hypertension, diabetes, sleep apnea, and heart failure.
Writing in Arthritis Research & Therapy, Jasvinder Singh, MD, of the University of Alabama at Birmingham, pointed out that little is known about how gout affects the known comorbidities and their outcomes and that published qualitative research has focused on gout’s effect on quality of life, and there is also an under-representation of women in studies to date.
He sought to shed light using a trajectory model developed by Corbin and Strauss to form a qualitative description of the effect gout has on comorbidities.
The Study
A nominal group study was conducted by looking at 45 patients with gout in nine nominal groups. The trajectory model assessed body (organ system and function), biographical time (explicit narrative that gives meaning and purpose to a person’s life), and conceptions of self (role identity, social identity). The three components were reported as answers to the question, “How does gout or its treatment affect your other conditions and their treatment?”
The Results
The study showed that the effects of gout or gout treatment on comorbidities and their management included the following:
• Three groups rated the interaction of gout medications with medications for other medical conditions as a top concern
• Seven groups rated gout’s effect in worsening medical comorbidities, including hospitalizations, as a high concern
• Three groups cited worsening anxiety and depression as a top concern
• Three groups considered changes in diet as a primary concern
• Three groups cited new disease diagnosis on top of gout as a concern
• Two groups named irreversible joint damage as a top concern
• Four groups listed weight gain and inability to exercise as a problem
• Three groups cited misdiagnosis of their gout as another problem
In addition, the effects of gout or its treatment on daily life included the following:
• Six groups cited the negative effect of gout on daily life and activities, including the ability to work and social activities, as a concern
• All nine groups cited medication adverse effects as a problem
• One group cited weight loss as a negative effect on quality of life
• Three groups cited high cost as a concern
There were no observable differences between men and women on the impact of gout on their lives.
Implications for Physicians
Singh noted the following as the major clinical implications:
• Complaints with regard to loss of self, loss of role identity, and lower quality of life dominate within the gout population
• Although treatment of gout and its symptoms is important, physicians should not discount patients’ perceptions and the effect of gout on their comorbid conditions
• Physicians should, as a routine, ask patients how gout affects their lives and validate the concerns
• How physicians can change these comorbid interactions is unclear

This article originally appeared on our partner’s website Rheumatology Network, which is a part of UBM Medica. (Free registration is required.)
• Primary Source
Arthritis Research & Therapy
Source Reference: Singh JA “Gout and comorbidity: a nominal group study of people with gout” Arthritis Res Ther 2017; DOI: 10.1186/s13075-017-1416-1418.