| 1. |
- Bergsten, Ulrika, et al.
(författare)
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Gender differences in illness perceptions and disease management in patients with gout, results from a questionnaire study in Western Sweden.
- 2023
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Ingår i: BMC musculoskeletal disorders. - 1471-2474. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Aims were to examine gender differences in patients with gout with regard to a) self-reported gout severity, b) illness perceptions (IP), c) impact on daily activities and Quality of Life (QoL), d) advice from healthcare professionals, e) having changed dietary- or alcohol habits.Adult patients with gout identified in primary and secondary care in Sweden between 2015 and 2017 (n=1589) were sent a questionnaire about demographics, gout disease severity, IP (using the Brief Illness Perception Questionnaire, (B-IPQ)) and disease management. T-tests, Chi square tests, ANalysis Of VAriance (ANOVA) and linear regression models were used for gender comparisons.Eight hundred sixty-eight patients responded to the questionnaire. Women, n=177 (20%), experienced more severe gout symptoms (p=0.011), albeit similar frequencies of flares compared to men. Women experienced modest but significantly worse IP with regard to consequences, identity, concerns and emotional response (p<0.05) as well as daily activities such as sleeping (p<0.001) and walking (p=0.042) and QoL (p=0.004). Despite this and a higher frequency of obesity in women (38 vs 21%, P<0.001) and alcohol consumption in men (p<0.001), obese women had received significantly less advice regarding weight reduction (47 vs 65%, p=0.041) compared to obese men. On the other hand, women reported having acted on dietary advice to a larger degree.Despite only modestly worse gout severity and perception, women appear to have been given less information regarding self-management than men. These gender differences should be given attention and addressed in clinical care.
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| 2. |
- Dehlin, Mats, et al.
(författare)
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Dr. Dehlin, et al reply.
- 2019
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Ingår i: The Journal of rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 46:11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- It was with great interest that we read the letter from Watson and colleagues1 describing their investigation of how a primary care diagnosis of gout compares to a primary care diagnostic rule for gout and the 1977 American Rheumatism Association (ARA) classification criteria of acute arthritis of primary gout. They present positive predictive values (PPV) of 74% for the diagnostic rule and 80% for the ARA criteria.
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| 3. |
- Dehlin, Mats, 1968, et al.
(författare)
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Lifestyle factors and comorbidities in gout patients compared to the general population in Western Sweden: results from a questionnaire study.
- 2022
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Ingår i: Scandinavian journal of rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 51:5, s. 390-393
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to identify lifestyle factors associated with gout in patients with prevalent gout compared to the general population.Adult patients with gout identified in primary and secondary care in Western Sweden between 2015 and 2017 were sent a questionnaire asking about demographics, lifestyle, and comorbidities. Five age- and gender-matched controls were identified in a random sample of 52348 individuals aged 16-84years who participated in the National Public Health survey in Sweden, year 2015. Logistic regression models were used to compare cases and controls with regard to lifestyle factors and comorbidities.Of the 1589 invited gout patients, 868 (55%) responded. After matching for age and gender, 728 were included in the analysis (82.4% male; mean±sd age 69.3±10.5 years for men and 71.8±9.9 years for women with gout). Male and female gout patients were significantly more likely to be overweight or obese (men 79% vs 66%; women 78.5% vs 65.3%), to have binge-drinking behaviour (men 29.9% vs 11%; women 13.7% vs 2.9%), and to be ex-smokers, compared to controls. Moreover, male gout patients reported lower levels of physical activity, while diabetes and hypertension were more common in both genders with gout than in controls.In this questionnaire study, gout patients reported significantly more obesity and binge-drinking behaviour and less physical activity than controls. This suggests that there are great unmet needs for the management of lifestyle factors, particularly regarding overweight/obesity and binge drinking, in patients with gout.
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| 4. |
- Dehlin, Mats, 1968, et al.
(författare)
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Sex and country differences in gout: cross-country comparison between Sweden and the UK.
- 2023
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Ingår i: Scandinavian journal of rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 52:6, s. 673-682
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Tidskriftsartikel (refereegranskat)abstract
- Compare characteristics, sex differences, and management of gout in Sweden and the UK.The results from two separate primary care gout surveys from Sweden and the UK were compared. Participants aged ≥18 years with gout were sent a questionnaire asking about lifestyle, gout characteristics, uratelowering therapy (ULT), comorbidities, disability, and disease impact. For sex comparison, participants were pooled across countries.In total, 784 (80% male) participants from Sweden and 500 (87% male) from the UK were included. Swedish patients were significantly older at gout onset, mean (SD) age 72 (12) versus 63 (13) years, (p<0.0001), with more comorbidities, and more frequent use of ULT (48% vs 35%, p=0.0005, age-adjusted). Use of alcohol and diuretics was significantly more common among UK patients, who also reported a higher number of gout flares, mean (SD) 2.2 (1.7) versus 1.6 (3.6), (p=0.003) age-adjusted. Females with gout were older at gout onset, mean (SD) age 67 (13) versus 56 (15), (p<0.0001), more often obese, and reported higher use of diuretics. Furthermore, females reported greater impact of gout, more pain and physical limitations, whereas no sex differences were seen in ULT or flares.In the UK, gout was more frequently associated with modifiable risk factors. People with gout in Sweden were more commonly taking ULT and had lower frequency of gout flares and impact of gout. Females with gout more commonly took diuretics, had higher body mass index, and reported greater physical disability, which should be considered when managing gout in women.
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| 5. |
- Dehlin, Mats, 1968, et al.
(författare)
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The Validity of Gout Diagnosis in Primary Care: Results from a Patient Survey.
- 2019
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Ingår i: The Journal of rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 46:11, s. 1531-1534
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Tidskriftsartikel (refereegranskat)abstract
- Validate primary care diagnosis of gout by the Mexico and the Netherlands classification criteria.Questionnaires on gout characteristics were sent to all individuals aged ≥ 18 with ≥ 1 International Classification of Diseases, 10th ed. diagnosis of gout at 12 primary care centers.Positive predictive values for gout diagnosis ranged from 71% for the Netherlands criteria to 80% for the Mexico criteria. Maximum inflammation within 24 h was the most common reported symptom (86%).The vast majority of gout cases in primary care fulfill classification criteria and are valid for research purposes.
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| 6. |
- Ingvarsson, R. F., et al.
(författare)
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Good survival rates in systemic lupus erythematosus in southern Sweden, while the mortality rate remains increased compared with the population.
- 2019
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Ingår i: Lupus. - : SAGE Publications. - 1477-0962 .- 0961-2033. ; 28:12, s. 1488-1494
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Tidskriftsartikel (refereegranskat)abstract
- To ascertain the mortality rate and causes of death in patients with systemic lupus erythematosus (SLE) within a defined region in southern Sweden during the time period 1981-2014 and determine whether these have changed over time.In 1981, a prospective observation study of patients with SLE was initiated in southern Sweden. All incident SLE patients within a defined geographic area were identified using previously validated methods including diagnosis and immunology registers. Patients with a confirmed SLE diagnosis were then followed prospectively at the Department of Rheumatology in Lund. Clinical data was collected at regular visits. Patients were recruited from 1981 to 2006 and followed until 2014. The patient cohort was split into two groups based on the year of diagnosis to determine secular trends. Causes of death were retrieved from medical records and from the cause of death registry at The National Board of Health and Welfare in Sweden.In all, 175 patients were diagnosed with SLE during the study period. A total of 60 deaths occurred during a total of 3053 years of follow-up. In the first half of the study inclusion period 46 patients died, compared with 14 in the latter. The majority of patients (51.7%) died of cardiovascular disease. Infections caused 15% of the deaths and malignancy was the cause of death in 13.3% of patients. SLE was the main cause of death for 6.7% of the patients and a contributing factor for half of the patients. Standardized mortality ratio was increased in patients by a factor of 2.5 compared with the general population. Deaths occurred at an even rate throughout the whole observation period. No significant difference in standardized mortality ratio was observed between genders but was increased in older female patients. Furthermore, secular mortality trends were not identified.In this long-term epidemiologic follow-up study of incident SLE, we report a substantially raised mortality rate amongst SLE patients compared with the general population. The mortality rates have not changed significantly during the observation period that spanned three decades. The main cause of death was cardiovascular disease and this finding was consistent over time.
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| 7. |
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| 8. |
- Landgren, Anton J., 1989, et al.
(författare)
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Cardiovascular risk factors are highly overrepresented in Swedish patients with psoriatic arthritis compared with the general population.
- 2020
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Ingår i: Scandinavian journal of rheumatology. - : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 49:3, s. 195-99
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to determine the prevalence of cardiovascular risk factors in patients with psoriatic arthritis (PsA) followed at a large Swedish Rheumatology Clinic, and to compare differences in cardiovascular risk factors between men and women with PsA and with the general population. Method: A questionnaire was sent to patients with PsA registered at the Rheumatology Clinic at Sahlgrenska University Hospital, Gothenburg (n=982). Comparisons with the general population were made using data from the Swedish National Public Health Survey. Descriptive statistics are presented. Body mass index (BMI) was calculated using self-reported height and weight. Results: Overall, 692 (70.6%) of the patients with PsA responded. The mean±sd age was 55.6±11.4years and 52% were women. Obesity (BMI ≥30 kg/m2) was more prevalent (p<0.001) in patients with PsA (28.6%) than in matched subjects from the general population (16.3%). Hypertension was also more prevalent (p<0.001) in PsA (40.3%) than in matched subjects from the general population (24.1%), as was diabetes, with a prevalence of 10.5% in the PsA population compared with 6.2% in matched subjects (p<0.001). Conclusion: We found obesity to be highly overrepresented in patients with PsA compared with matched subjects from the general population. This difference was particularly seen in women with PsA. Hypertension and ever smoking were also more prevalent in women with PsA compared with matched subjects from the general population.
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| 9. |
- Landgren, Anton J., 1989, et al.
(författare)
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Cardiovascular risk factors in gout, psoriatic arthritis, rheumatoid arthritis and ankylosing spondylitis: a cross-sectional survey of patients in Western Sweden.
- 2021
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Ingår i: RMD open. - : BMJ. - 2056-5933. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to compare traditional (trad) cardiovascular risk factors (CVRFs) among patients with gout, psoriatic arthritis (PsA), rheumatoid arthritis (RA) and ankylosing spondylitis (AS) stratified by sex.A survey was sent to patients with gout (n=1589), PsA (n=1200), RA (n=1246) and AS (n=1095). Patients were retrieved from Sahlgrenska University Hospital, the hospitals of Uddevalla and Skövde, and 12 primary care centres in Western Sweden. The prevalence of self-reported trad-CVRFs was compared between diagnoses by age standardisation with the 2018 population of Sweden as the standard population.In total, 2896 (56.5%) of 5130 patients responded. Hypertension was the most frequently found comorbidity, reported by 65% of patients with gout, 41% with PsA, 43% with RA and 29% with AS. After age standardisation, women and men with gout had significantly more obesity (body mass index ≥30kg/m2), hypertension, diabetes, hyperlipidaemia and multiple trad-CVRFs, compared with those with PsA, RA and AS. Obesity was significantly more common in PsA than in RA. In women, obesity, hypertension and multiple trad-CVRFs were more frequently reported in PsA than in RA and AS, whereas similar prevalence of CVRFs and coexistence of multiple trad-CVRFs were found in men with PsA, RA and AS.Women and men with gout had the highest prevalence of trad-CVRFs. Differences in occurrence of CVRFs by sex were found in patients with PsA, RA and AS. In women, patients with PsA had higher occurrence of trad-CVRFs than those with RA and AS, whereas in men the distribution of CVRFs was similar in PsA, RA and AS.
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| 10. |
- Landgren, Anton J., 1989, et al.
(författare)
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Health-related quality of life by gout severity in women and men with gout in primary care: results from a questionnaire study in Western Sweden.
- 2023
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Ingår i: Scandinavian journal of rheumatology. - 1502-7732. ; 52:6, s. 683-8
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to compare health-related quality of life (HRQoL) by gout severity, overall and by sex.A questionnaire was sent to patients with gout (n=1444) identified at 12 primary care centres in Western Sweden. The questionnaire asked about comorbidities, gout-specific aspects, and HRQoL, using the RAND 36-Item Health Survey. Responders were divided into 'mild', 'moderate', or 'severe' gout based on the number of self-reported flares (0, 1-2, ≥3) during the past 12months.Out of 1444 gout patients, 784 (54.3%) responded to the questionnaire. Among the respondents, 673 [560 (83.2%) men and 113 (16.8%) women] provided answers regarding the number of gout flares in the past year. Of these, 322 (47.8%), 218 (32.4%), and 133 (19.8%) were classified as having mild, moderate, and severe gout, respectively. Allopurinol use was more frequent in those with mild disease. In more severe gout, HRQoL was reduced compared to less severe gout [severe vs mild gout, mean values for physical component summary (PCS) score 39.5 vs 43.6, p =0.002, and mental component summary (MCS) score 46.6 vs 51.1, p <0.001]. When excluding those with a flare in the past month, the HRQoL was still worse in severe gout (vs mild), although differences were attenuated and not statistically significant for the PCS and for women.Gout severity, defined as the number of flares during the past year, was associated with significant reductions in HRQoL.
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