Perception of Gout as a Lifestyle Disease Reinforces Stigma

Rheumatologists’ perceptions of patients with gout reinforce negative stereotypes, according to study results presented at European Alliance of Associations for Rheumatology (EULAR) Congress 2022, held onsite from June 1 to 5 in Copenhagen, Denmark.

Researchers in the United States surveyed 106 practicing rheumatologists about their perceptions of, experiences with, and recommendations for patients with controlled and uncontrolled gout compared with patients with rheumatoid arthritis (RA).

Survey questions assessed the perceptions of the rheumatologists on:

• Patient compliance with treatment recommendations;
• Patient responsibility for their disease condition;
• Factors contributing to the disease; and
• Efficacy of the treatment recommendations.

Regardless of whether the patients had controlled or uncontrolled gout, the rheumatologists’ responses were similar, suggesting that their perceptions might originate from their thoughts on gout itself, instead of how well the disease was managed. Because the responses did not significantly differ, the data for the 2 gout cohorts were combined.

Rheumatologists perceived patients with gout would be significantly less likely to comply with treatment recommendations (P <.05) and were significantly more responsible for their condition (P <.05) compared with patients with RA.

The rheumatologists perceived that lifestyle choices influenced disease condition in patients with gout to a greater degree than patients with RA, listing personal behavior, diet, body mass index, and compliance with treatment as contributing factors to disease state (all P <.01). They believed that the most effective treatments for gout included change in diet, increased activity levels, and weight loss (all P <.01) compared with the biological treatments they deemed more effective for RA management (P<.01).

The study authors concluded, “Despite good intentions when treating gout patients, rheumatologists appear to have causal beliefs and illness perceptions that reflect negative gout-related stereotypes…. Educating physicians, particularly rheumatologists, on the myths surrounding gout may improve clinical care and, therefore, patient outcomes.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

Reference

Edwards NL, LaMoreaux B, Magerman A, Hunger J, Vitriol J. Does a gout stigma among rheumatologists influence perceptions of patients and treatment decisions?. Presented at: EULAR Congress 2022; June 1-4, 2022. Copenhagen, Denmark. Abstract POS0283.