title: Racial differences in health-related quality of life and functional ability in patients with gout.
abstract: To compare the health-related quality of life (HRQOL) and the functional ability by race in patients with gout.
  
  
  
  In a 9-month prospective cohort multicentre study, patients with gout self-reported race, dichotomized as Caucasian or African American (others excluded). We calculated HRQOL/function scores adjusted for age, study site and college education for Short Form-36 (SF-36; generic HRQOL), Gout Impact Scale (GIS; disease-specific HRQOL) and HAQ-disability index (HAQ-DI; functional ability). Longitudinally adjusted scores were computed using multivariable mixed-effect regression models with a random patient effect and fixed sequential visit effect (3-monthly visits).
  
  
  
  Compared with Caucasians (n = 107), African Americans (n = 60) with gout were younger (61.1 vs 67.3 years) and had higher median baseline serum urate (9.0 vs 7.9 mg/dl) (P < 0.01). African Americans with gout had worse HRQOL scores on three SF-36 domains, the mental component summary (MCS) and two of the five GIS scales than Caucasians [mean (se); P ⩽ 0.02 for all]: SF-36 mental health, 39.7 (1.1) vs 45.2 (0.9); SF-36 role emotional, 42.1 (4.2) vs 51.4 (4.2); SF-36 social functioning, 36.0 (1.1) vs 40.0 (0.9) (P = 0.04); SF-36 MCS, 43.2 (3.1) vs 50.0 (3.2); GIS unmet treatment need, 37.6 (1.6) vs 31.5 (1.4); and GIS concern during attacks, 53.3 (3.7) vs 47.4 (3.7). Differences between the respective HAQ-DI total scores were not statistically significant; 0.98 (0.1) vs 0.80 (1.0) (P = 0.11). Racial differences in SF-36 mental health, role emotional and MCS scales exceeded, and for HAQ-DI approached, the minimal clinically important difference thresholds.
  
  
  
  African Americans with gout have significantly worse HRQOL compared with Caucasians. Further research is necessary in the form of studies targeted at African Americans on how best to improve these outcomes.
authors.affiliation: Medicine Service, Birmingham VA Medical Center Jasvinder.md@gmail.com.|Department of Medicine, School of Medicine.|Division of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.|Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, MN.
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.affiliation: Department of Medicine, School of Medicine.|Division of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Aseem
authors.initials: A
authors.lastname: Bharat
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
authors.affiliation: Department of Biostatistics, VA Greater Los Angeles Healthcare System.
authors.forename: Cleopatra
authors.initials: C
authors.lastname: Aquino-Beaton
authors.affiliation: Department of Biostatistics, VA Greater Los Angeles Healthcare System.
authors.forename: Jay E
authors.initials: JE
authors.lastname: Persselin
authors.affiliation: Department of Medicine, University of California, Los Angeles, CA.
authors.forename: Erin
authors.initials: E
authors.lastname: Duffy
authors.affiliation: Department of Medicine, University of California, Los Angeles, CA.
authors.forename: David
authors.initials: D
authors.lastname: Elashoff
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI.|Department of Medicine, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
authors.forename: Puja P
authors.initials: PP
authors.lastname: Khanna
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006073:Gout / Q000503:physiopathology* / Q000523:psychology; D006301:Health Services Needs and Demand; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D012720:Severity of Illness Index; D058992:Social Participation; D014481:United States; D014493:United States Department of Veterans Affairs; D044465:White People
keywords: HRQOL; disparity; function; gout; health-related quality of life; race; racial