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Rebranding Gout: Could a Name Change for Gout Improve Adherence to Urate-Lowering Therapy?

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Abstract

Gout is the most common form of inflammatory arthritis in men, yet both patients and the public often do not recognise gout as a form of arthritis. Instead, due to historical misconceptions, gout is typically seen as a lifestyle disease caused by poor diet. In reality, there are a number of risk factors that contribute to gout, including genetic factors. Views of gout as precipitated by lifestyle alone can lead to stigma, and maladaptive beliefs that it should be treated primarily through dietary changes. This is thought to contribute to poor uptake of, and adherence to, effective pharmaceutical treatments. Gout has some of the poorest medication adherence rates of any chronic disease, contributing to suboptimal health outcomes for patients. Recent research suggests that when gout is referred to as ‘urate crystal arthritis’ (a rarely used name for gout), the perception of the disease by members of the public was more accurate. It was viewed as being less under personal control (i.e. less appropriately managed by behaviours such as dietary intake), and more appropriately managed by long-term medical treatment. This finding raises the possibility that patients themselves might also benefit from gout being explicitly labelled as arthritis. Indeed, parallels can be drawn between this case and other diseases that have recently had their names changed to improve outcomes, namely primary biliary cirrhosis and schizophrenia. A movement away from the term gout may benefit those living with the disease by changing illness perceptions and increasing uptake of, and adherence to, guideline-recommended treatment(s).

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Funding

Richard O Day’s research was supported by National Health and Medical Research Council (NH&MRC) Program Grant number APP 1054146; Kate Faasse is supported by an Australian Research Council Discovery Early Career Research Award (DE180100471).

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Authors and Affiliations

  1. St Vincent’s Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia

    Matthew J. Coleshill PhD, Eindra Aung PhD, Jane E. Carland PhD, Sophie Stocker PhD & Richard O. Day MD

  2. Department of Clinical Pharmacology, & Toxicology, Therapeutics Centre, St Vincent’s Hospital, Sydney, Level 2 Xavier Building, Darlinghurst, NSW, 2010, Australia

    Matthew J. Coleshill PhD, Eindra Aung PhD, Jane E. Carland PhD, Sophie Stocker PhD & Richard O. Day MD

  3. School of Psychology, UNSW Sydney, Sydney, NSW, Australia

    Kate Faasse PhD

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  1. Matthew J. Coleshill PhD
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Correspondence to Matthew J. Coleshill PhD.

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Coleshill, M.J., Aung, E., Carland, J.E. et al. Rebranding Gout: Could a Name Change for Gout Improve Adherence to Urate-Lowering Therapy?. Ther Innov Regul Sci 55, 138–141 (2021). https://doi.org/10.1007/s43441-020-00198-0

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