Is gout associated with reduced quality of life? A case-control study

Objectives. To compare quality of life (QOL) between gout cases and controls in a primary care population and to investigate whether impaired QOL in gout is secondary to co-morbid factors or to intrinsic factors related to gout itself. Methods. A postal questionnaire was sent to all adults aged over 30 yrs registered with two general practices. The questionnaire assessed a history of gout (doctor diagnosed, or episodes suggestive of acute crystal synovitis) and medical and musculoskeletal co-morbidities. QOL was assessed using the WHOQoL-Bref instrument. Possible cases of gout attended for clinical assessment where the diagnosis was verified on clinical grounds. Overall QOL, satisfaction with health and QOL across four domains were compared between gout cases and controls and then entered into a linear regression model adjusting for gout, age, gender, body mass index and medical and musculoskeletal co-morbidities. Results. Of 13684 questionnaires mailed, 3082 completed questionnaires were returned (23%). From 289 suggested cases of gout, 137 cases were confirmed by clinical assessment. Compared with controls, cases had impaired overall QOL (15.67 vs 16.41, P=0.003), satisfaction with health (13.16 vs 14.45, P< 0.001) and physical health-related QOL (14.08 vs 15.95, P< 0.001). On multi-variate analysis, gout remained associated with impaired physical health-related QOL (beta = -0.059, P= 0.001) but not overall QOL (beta = -0.024, P= 0. 198) or satisfaction with health (beta = -0.028, P= 0. 142). Conclusions. Gout associates with poor overall QOL mainly resulting from associated co-morbidity. Physical health-related QOL, however, remains impaired after adjustment for co-morbidities.