Outcomes of Care Among Patients with Gout in Europe: A cross-sectional survey

Abstract

Objective To assess health- and patient-centered outcomes in gout across Europe, and explore patient-, care-, and country-level characteristics associated with these outcomes. Methods Patients with self-reported physician-diagnosed gout from 14 European countries completed an online survey. Multivariable mixed-effect logistic and linear regressions were computed for health outcomes (gout flare recurrence) and patient-centered outcomes (patient satisfaction with current medication, and unaddressed goals), accounting for clustering within countries. The role of patient-, care- and country-level factors was explored. Results 1029 patients, predominantly diagnosed by a general practitioner, participated. One or more gout flares were reported by 70% of patients and ≥3 flares by 32%. Gout patients reported 1.1±1.2 unaddressed goals, and 80% were satisfied with current medication. Patients with ≥3 and ≥1 flares were less likely to be treated with urate-lowering therapy (ULT) [OR:0.52(0.39-0.70) and OR:0.38(0.28-0.53), respectively], but more likely to have regular physician visits [OR:2.40(1.79-3.22) and OR:1.77(1.30- 2.41)]. Three or more gout flares were also associated with lower satisfaction [OR:0.39(0.28-0.56)], and more unaddressed goals [B:0.36(0.19-0.53)]. Notwithstanding, the predicted probability of being satisfied was still between 57% and 75% among patients with ≥3 flares but who were not receiving ULT. Finally, patients from wealthier and Northern European countries more frequently had ≥3 gout flares. Conclusion Across Europe, many gout patients remain untreated despite frequent reported flares. Remarkably, a substantial proportion of them were still satisfied with gout management. A better understanding of patients' satisfaction and its role in physicians' gout management decisions is warranted to improve quality of care and gout outcomes across Europe.