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The disutility of chronic gout

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Abstract

Introduction

Gout is a chronic painful inflammatory arthritis. Data regarding the impact of gout on health-related quality of life, however, are limited.

Methods

We interviewed patients with chronic stable gout. Health status was measured by using the Short Form 36 (SF-36) physical component summary (PCS) and physical component summary (MCS) and the Health Assessment Questionnaire-Disability Index (HAQ-DI). Direct preference-based measures included a health rating scale (RS), the time tradeoff (TTO), and standard gamble (SG) for one’s current health state with gout and current health state without gout; indirect preference-based measures included the SF-6D and the EQ-5D. Disutilities for gout were assessed by subtracting preference scores for current health states with gout from those for current health without gout and were compared between patients ranking gout as their top health concern versus the rest of the patients.

Results

Of the 80 interviewees, 72 (90%) were male, 55 (69%) were Caucasian, and the mean (SD) age was 60 (11) years. The mean SF-36 PCS and MCS scores were 38.9 and 48.6, respectively. The mean (SD) SF-6D score was 0.68 (0.13) and the mean (SD) EQ-5D score was 0.73 (0.23). The mean (SD) RS disutility for gout was 0.05 (0.12), the mean TTO disutility was 0.03 (0.12), and the mean SG disutility was 0.02 (0.11). The RS disutilities of subject patients who ranked gout as their top concern (n = 17) trended towards being statistically significantly larger than those of the remaining patients, P = 0.06 but their TTO and SG disutilities were similar to those of the remaining patients.

Conclusion

Although physical functioning of patients with gout is often compromised, patients with chronic stable gout do not assign a large disutility to gout per se. Still, patients who rank their gout as their top health concern tend to assign greater RS disutility to gout than do other patients.

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Notes

  1. Accessed www.drugstore.com (Internet Communication).

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Acknowledgements

Dr. Khanna was supported by a National Institutes of Health Award (NIAMS K23 AR053858-01A1). Mr. Yontz was supported by a grant from the American Federation of Aging, Ohio Chapter. Dr. Tsevat was supported in part by a National Center for Complementary and Alternative Medicine award (grant # K24 AT001676). TAP Pharmaceuticals Products Inc. provided funding for the study but had no role in data collection, analysis, manuscript preparation, and the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, 1000 Veteran Avenue, Rm 32-59 Rehabilitation Building, Los Angeles, CA, 90095, USA

    Dinesh Khanna & Grace S. Park

  2. Department of Health Services, School of Public Health, University of California at Los Angeles, Los Angeles, CA, USA

    Dinesh Khanna

  3. Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA

    Mansoor Ahmed, Shaari S. Ginsburg & Joel Tsevat

  4. University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Dustin Yontz & Joel Tsevat

  5. Institute for the Study of Health, University of Cincinnati, Cincinnati, OH, USA

    Anthony Leonard & Joel Tsevat

  6. Veterans Affairs Medical Center, Cincinnati, OH, USA

    Joel Tsevat

Authors
  1. Dinesh Khanna
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  2. Mansoor Ahmed
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  3. Dustin Yontz
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  4. Shaari S. Ginsburg
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  5. Grace S. Park
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  6. Anthony Leonard
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  7. Joel Tsevat
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Correspondence to Dinesh Khanna.

Appendix

Appendix

Ceiling and floor effects of health status and preference-based scores

Health status instrument

Ceiling effect

Floor effect

SF-36

Physical component summary, n (%)

0 (0)

0 (0)

Mental component summary, n (%)

0 (0)

0 (0)

Physical functioning, n (%)

9 (11)

0 (0)

Role physical, n (%)

17 (21)

3 (4)

Bodily pain, n (%)

6 (8)

1 (1)

General health, n (%)

1 (1)

1 (1)

Vitality, n (%)

3 (4)

0 (0)

Social functioning, n (%)

20 (25)

1 (1)

Role emotional, n (%)

25 (31)

2 (2)

Mental health, n (%)

7 (8)

1 (1)

HAQ-DI, n (%)

22 (28)

0 (0)

Preference-based measure

RS,a n (%)

1 (1)

1 (1)

TTO,a n (%)

20 (25)

2 (3)

SG,a n (%)

18 (22)

1 (1)

SF-6D, n (%)

0 (0)

1 (1)

EQ-5D, n (%)

18 (22)

0 (0)

  1. aCurrent health with gout. HAQ-DI, health assessment questionnaire-disability index; RS, rating scale; TTO, time tradeoff; SG, standard gamble

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Khanna, D., Ahmed, M., Yontz, D. et al. The disutility of chronic gout. Qual Life Res 17, 815–822 (2008). https://doi.org/10.1007/s11136-008-9355-0

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