Article Text
Abstract
Background Gout is one of the most common form of inflammatory arthritides, data regarding impact of gout on health related quality of life do not include data on deprivation, a confounder. Most studies have also been conducted in secondary (hospital) care.
Objectives This study aimed to investigate the relationship between quality of life, lifestyle factors and deprivation scores in patients with gout in primary care.
Methods Two general practice surgeries in North England were chosen for this study, one covering an affluent area and the other covering areas of deprivation. Patients with gout were identified using standard primary care software. After obytining consent, two questionnaires; the Short Form 36 (SF-36) v2 assessing quality of life and the Leeds Health Questionnaire assessing lifestyle factors were posted to the patients identified. Deprivation was assessed using the patient’s postcode using the index of multiple deprivation (IMD). Normative data for the UK adult population was used as a comparator for the SF-36 indicators of quality of life. Student T test was used to compare quality of life scores between the normative population. A correlation co-efficient was used to examine the relationship between deprivation and the domains of the SF-36. A linear model adjusting for lifestyle factors was fitted to determine whether any association between gout and deprivation was confounded by lifestyle factors identified in the Leeds Heath Questionnaire.
Results 251 patients were identified and 127 returns were obtained, giving a return rate of 51%. 100 (79%) were male, median age was 68 years (IQR 60,76 years), median body mass index was 27.5 kg/cm2 (IQR 24.7,30.7 kg/cm2). The scores of physical health Component Summary (PCS) of the short form 36 version 2 and its related 6 domains (Vitality, Physical Functioning, Bodily Pain, General Health, Role Physical, social functioning) were significantly lower in patients with gout than those reported for the general UK population (p<0.05). There was no significant difference in the remaining 2 domains (Role Emotional and Mental Health) and the Mental health Component Summary. A strong correlation existed between lower physical quality of life in patients with gout with reduced PCS scores and Deprivation (r=0.70).No significant correlation could be identified between reduced PCS in patients with gout or between Deprivation and the following factors (age, gender, smoking status, body mass index, exercise, alcohol intake, general health and disability). The linear model identified a relationship between deprivation and lower physical quality of life that was not ameliorated after adjusting for lifestyle factors in the Leeds questionnaire (co-efficient -0.81 95%CI -0.98,-0.65).
Conclusions Within the limitations of the study; it was concluded that (1) Physical health related Quality of Life is lower in patients with gout in comparison to general population, and (2) Reduced health related quality of life in patients with gout is more evident among the more deprived patients which persisted after adjusting for lifestyle factors.
Disclosure of Interest None Declared