Gout Impacts Employment, Mitigated by Effective Management

Cesar Diaz-Torne, MD, PhD

Credit: Doctoralia

Gout and the characteristics of work influenced employment experiences for people with gout, which could be improved by effective management of gout.¹

“Some people with gout experience shame, embarrassment and social stigma due to cultural narratives that gout is a self-inflicted disease of dietary excess. These characteristics may cause people with gout to have unique experiences and challenges within the workplace. Although prior qualitative studies have identified the impact of gout on various domains, there have been no prior qualitative studies designed to specifically examine the impact of gout on employment. This study aims to understand the impact of gout on paid work,” lead investigator Cesar Diaz-Torne, MD, PhD, Faculty of Medical and Health Sciences, Department of Medicine, The University of Auckland, New Zealand, and Servei de Reumatología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, and colleagues wrote.¹

Diaz-Torne and colleagues conducted semistructured interviews in Spain and Aotearoa/New Zealand with people with gout who had experienced a gout flare during employment. The interviews, data from which were analyzed thematically, explored how the flare had impacted employment, job changes, disclosure, and coworker reactions.

The investigators conducted a total of 18 interviews. Interviewees were mostly male (89%) and had a mean age of 52.9 years. They identified 6 themes during the interviews: gout factors, work factors, social experience, emotional experience, physical experience, and the positive impact of gout management. Gout factors, including the characteristics of the disease, such as pain intensity, tophi, and affected joints, and work factors, including physical job requirements and workplace flexibility, determined the work experience. Work experience was divided into physical (from total incapacity to working despite pain), emotional (feeling responsible, embarrassment, guilt and depression) and social (including disclosure responses and financial impact). Gout management, including rapid gout flare management and urate-lowering therapy, improved the work experience by reducing the number of flares and the intensity of pain and allowing work attendance and participation.¹

“This qualitative study has examined the impact of gout on employment. The possibility of losing work is an important issue for people with gout. The burden of inflammatory diseases on employment has been studied in other rheumatic diseases. This study has shown that both the characteristics of the disease and the job determined experiences with employment. Working with gout had physical, emotional and social impacts. Lastly, effective gout management improved experiences in the workplace,” Diaz-Torne and colleagues wrote.¹

Gout’s impact on quality of life has been well-documented. Earlier this month, investigator led by Vibeke Strand, MD, associated with the Division of Immunology/Rheumatology at Stanford University School of Medicine, conducted qualitative interviews of 20 people with chronic gout, to further describe its impact.²

They found that the most commonly reported symptoms were bodily pain (90.0%, n = 18), joint tenderness (90.0%, n = 18), joint swelling (90.0%, n = 18), and joint pain (80.0%, n = 16). The most frequently reported impacts were difficulties climbing a flight of stairs (100.0%, n = 20), climbing several flights of stairs (100.0%, n = 20), climbing 5 steps (95.0%, n = 19), completing chores (95.0%, n = 19), and running errands and shopping (95.0%, n = 19).All items evaluated from the Health Assessment Questionnaire-Disability Index (HAQ-DI) and Medical Outcomes Survey Short Form-36 (SF-36) were reported by at least 25% of subjects and mapped to concepts elicited by participants.²

REFERENCES

1. Diaz-Torne C, Pou MA, Horne A, Gasteiger C, Dalbeth N. ‘Gout was like the boss’. A qualitative study exploring the impact of gout on employment. RMD Open. Published online August 19, 2024. doi.org/10.1136/rmdopen-2024-004443
2. Strand V, Pillinger MH, Oladapo A, Yousefian C, Brooks D, Kragh N. Patient Experience with Chronic Refractory Gout and Its Impact on Health-Related Quality of Life: Literature Review and Qualitative Analysis. Rheumatol Ther. Published online August 5, 2024. doi:10.1007/s40744-024-00697-8.