Alternate Warm and Cold Therapy (AWCT) on Uricemia, Sleep, Pain, Functional Ability, and Quality of Life (USPFQoL) in Patients with Gout: A Path Forward

Abstract

Objective. To understand the impact of alternate warm and cold therapy (AWCT) on uricemia, sleep, pain, functional ability, and quality of life in gout patients. Methods. A quasiexperimental, nonequivalent control group, pre and posttest design was adopted among 120 gout patients. The data were collected on demographics, comorbidities, pain level, joint swelling/joint tenderness, patient global assessment of response to treatment (PGART), health-related quality of life (HRQoL) with SF-36, sleep quality by Pittsburgh Sleep Quality Index (PSQI), and serum uric acid and assessed. Descriptive and inferential statistics were used to analyze the data. Results. Patients had mean age of 58 and 61 years, mean number of comorbidities was 1.8 and 1.4, as well as presence of arthritic comorbidities except gout was 1.1 and 0.8 among study and control group participants, respectively. Pain ( $p<0.001$ ), PGART ( $p=-0.01$ ), HRQoL, sleep quality, and level of SUA (mg/dl) improved significantly ( $p<0.01$ ) among the study group over study periods. It affirms that the AWCT is effective in reducing pain, functional disability, and SUA, as well as improving the sleep quality and HRQoL of the gout patients. There was a reduced incidence of gout flares ( $p<0.001$ ), and taking additional medicines for pain ( $p<0.01$ ) was statistically significant among study participants. Except social functioning, other domains of health were significantly ( $p<0.05$ ) affected by the comorbidities like hypertension, diabetes, heart disease, renal disease, and asthma/chronic obstructive pulmonary disease. Conclusions. Gout is independently associated with higher medical and arthritic comorbidity, and AWCT can be better and cost-effective alternative therapy for gout patients. In addition, it may lead to improved cardiac function, hypertension, and renal insufficiency.