Women With Gout Underinformed on Self-Management Practices
Even though women of all ages with gout experienced modestly worse condition severity and health issues perception when as opposed with gentlemen, they had been considerably less educated with regards to self-administration, according to a review revealed in BMC Musculoskeletal Issues.1
“Gout is a lot more prevalent in adult men and fewer effectively analyzed in females,” wrote Ulrika Bergsten, RN, PhD, Research and Improvement Section, Location Halland, and a group of Swedish investigators. “Several comorbidities… have been claimed to be much less regular in women of all ages when compared to males. Moreover, urate-reducing treatment (ULT) has been documented as significantly less regular in gals in comparison to men whereas the impact of gout on quality of lifetime (QoL) has been described as greater in women of all ages. These components, in addition to other folks, these types of as disease notion, can influence the care offered and quite possibly guide to gender variances in disease administration.”
Gout therapy revolves close to lowering serum urate, which involves ULT and way of living alterations. Encouraged nonpharmacological alterations are predominantly fat loss and nutritional variations this sort of as lessening the ingestion of seafood, alcoholic beverages, and meat.2
Grownup sufferers with gout, selected from 12 key and secondary treatment centers in Sweden involving 2015 and 2017, were being invited to take part in a questionnaire assessing gender differences concerning guys and women of all ages with gout. Facts gathered provided gout properties, demographics, illness severity, illness management, liquor use, dietary alterations, comorbidities, training, QoL, and ailment perception (evaluated working with the Transient Ailment Notion Questionnaire [B-IPQ]). The B-IPQ actions the psychological burden of ailment utilizing 8 dimensions: outcomes, timeline, particular manage, procedure control, identify, problems, comprehension, and psychological response.
Gender comparisons have been assessed making use of linear regression versions, T-checks, Chi sq. assessments, and Assessment Of VAriance (ANOVA). Purposeful status was established utilizing the Well being Evaluation Questionnaire (HAQ), even though the influence of ailment was evaluated utilizing the Gout Assessment Questionnaire (GAQ).
Of the 1589 sufferers despatched the questionnaire, 868 (54.6{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}) clients finished the study. Even though females (n = 177, 20{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}) noted somewhat increased symptom severity, with far more women reporting average, critical, and incredibly serious gout (P = .011), they had comparable flare frequencies when in comparison with guys. Ladies also noted modest but appreciably even worse disease perception regarding identification, issues, effects, and psychological response (P <.05), which remained after adjusting for age. Daily activities, including sleeping (P <.001) and walking (P = .042), as well as quality of life (QoL, P = .004) were also significantly worse when compared with men.
Although female respondents reported higher alcohol consumption (P <.001) and were more frequently obese (38{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 21{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, respectively P <.001), obese women received significantly less advice regarding weight reduction (47{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 65{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, respectively P = .041) when compared obese men. Women were more likely to act on dietary advice they received and reported more dietary changes, even though advice was more often given to men (53{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547} vs 22{a0ae49ae04129c4068d784f4a35ae39a7b56de88307d03cceed9a41caec42547}, respectively P <.001).
Investigators noted that the cross-sectional design limited the study and that results may not be generalizable to non-responders. They also stated that a possible misclassification of gout could have impacted findings however, previous studies of gout diagnoses have shown a high validity. Additionally, gender differences regarding physician advice and dietary changes may not be generalizable to other health care systems.
“Despite overall similarities, in our setting men and women are given different advice regarding disease management and differ with regard to implementation of given advice,” investigators concluded.1 “These differences call for further investigation of how to tailor and optimize health care advice and treatment of gout in subgroups of patients.”
References
- Bergsten U, Dehlin M, Klingberg E, Landgren AJ, Jacobsson LTH. Gender differences in illness perceptions and disease management in patients with gout, results from a questionnaire study in Western Sweden. BMC Musculoskelet Disord. 202324(1):300. Published 2023 Apr 15. doi:10.1186/s12891-023-06416-8
- Zhang W, Doherty M, Bardin T, Pascual E, Barskova V, Conaghan P, Gerster J, Jacobs J, Leeb B, Liote F, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheumatic Dis. 200665(10):1312–24.