(237) Patient, Caregiver, and Physician Perspectives on the Burden of Disease in Uncontrolled Gout and its Treatment: Concept Elicitation

Background: : Treatment options are limited for uncontrolled gout (UG), highlighting significant unmet needs. Studies on treatment experiences, decision-making, barriers, and the impact of UG on patient (PT) lives from the perspectives of PTs, caregivers (CGs), and physicians (PHYs) are limited.

Objective: : This research explored UG treatment experiences and impacts on health-related quality of life (HRQoL) with these participants.

Methods: : Qualitative 60-minute interviews were conducted anonymously from April -May 2024 with adult PTs, informal CGs, and PHYs who treat UG PTs. PT and CG interviews examined UG’s impact on HRQoL, adherence, factors driving treatment choices, treatment experiences, PHY interactions, and CG burden. PHY interviews assessed views on PT experiences, interactions, and treatment barriers/burdens. All interviews were coded in ATLAS.ti and thematically analyzed within and across the three groups.

Results: : 6 adult PTs, 4 CGs, and 8 PHYs (nephrologists,n=5; rheumatologists,n=3) completed interviews. PTs, CGs, and PHYs emphasized the wide-ranging impacts of UG on PTs’ lives due to severe pain and limited functionality associated with gout flares, including restricted mobility, inability to complete daily activities, and financial/employment impacts. Each participant highlighted the PTs’ emotional impacts, mainly frustration. CGs experience absenteeism, stress, physical impacts, disrupted routines, and time lost due to appointments/treatment sessions. PHYs consider multiple factors beyond efficacy and side effects in treatment decisions including, PT circumstances, disease severity, PT receptivity, medical history, side effects, and adherence. When considering treatment options, 50% of PTs prioritized side effects above other factors. PTs reported lack of efficacy, side effects, contraindications, travel burden, and access/insurance issues as additional barriers/burdens. PHYs and CGs cited inefficacy, side effects, access/insurance issues, comorbidities, costs, travel burden, and polypharmacy complexities as key barriers/burdens.

Conclusions: : PTs, CGs, and PHYs reported substantial burden and impact associated with UG and its treatment, suggesting the need for efficacious, safe, and less burdensome new treatment options, improving PTs’ quality of life.

Sponsorship:: Sobi Inc., Waltham, MA, USA