Background Coping patterns relate to demographic, socioeconomic, clinical, and therapy in patients with chronic diseases. In patients with rheumatic diseases, the evasive pattern is associated with the poorest outcome.
Objectives To describe coping patterns in patients with gout and its association with clinical variables and therapeutic adherence.
Methods The study includes a large inception cohort of patients with gout (ACR and CGD criteria) attending the Rheumatology departments of two major hospitals started in 2010. Most patients attending these two hospitals are poor and lack of financial support to cover the cost of medical care. Demographic, clinical, biochemical and therapy variables were recorded at baseline and every six months visits. The HAQ, EuROQoL, and Coping and Adherence questionnaires previously developed and validated in our country, were administered to all patients at every visit. Good adherence (GA) was defined by the intake of ≥80% of the doses prescribed. Statistical analysis included the t, Mann Whitney, χ2, and Fisher's tests.
Results There were 235 patients with gout (97% males, mean age 47.7±12.6 years and mean disease duration 14.2±10.2 years, 66% tophaceous) with an educational level of 9.4±4.2 years at baseline. Coping patterns were evasive in 70% of the patients whereas 14% and 13% showed a negative emotional pattern + others or a revalorative + direct pattern, respectively. The association between evasive pattern and a lower educational level, more severe disease (number of acute flares, bigger tophi size, HAQ, VAS for pain and general health) was highly significant. Evasive pattern was still the most frequently found in 43% patients that completed the 12th month evaluation. Interestingly, 78% of the patients with evasive pattern in both visits have good therapeutic adherence, but have more severe disease (see table).
Conclusions In patients with gout, evasive was the most frequent pattern of coping with the disease found in this study. Factors associated with this pattern include low educational level and severe disease. Interestingly, it does not seem associated with adherence and clinical response to treatment.
Disclosure of Interest None declared
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