Gout is associated with a high disease burden in older patients, probably translating into poor health-related quality of life (HRQOL) in addition to a higher rate of health care utilization and expenditures. The negative influence on HRQOL in these patients is attributable to the direct musculoskeletal manifestations and associated comorbidities, including the metabolic syndrome, renal failure, and cardiovascular and cerebrovascular disease.
Hanly and colleagues performed a 5-year, population-based, case-control retrospective analysis of older adults with gout. They also looked at which physicians tend to manage gout and with what medications.
Among 4071 cases and 16,281 controls, the 5-year incidence of gout was 4.4%. Most diagnoses (77%) were made by family physicians; only a few (0.02%) were identified by rheumatologists. Patients with gout visited their doctor more often than those who did not (28.1 vs 20.6 average visits per year) and were more likely to be hospitalized the first year after diagnosis. Drug use for gout treatment (NSAIDs, colchicine, corticosteroids) and prevention (allopurinol, probenecid, sulfinpyrazone) was significantly higher. The overall health care cost differential for patients with gout was plus $134 per month.
The authors noted that the burden of gout could be eased with improved accuracy of diagnosis and management.