{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:24:47Z","timestamp":1791548687280,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T00:00:00Z","timestamp":1543363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006662","name":"National Institute on Handicapped Research","doi-asserted-by":"publisher","award":["NIHR\u2010RP\u20102014\u201004\u2010026"],"award-info":[{"award-number":["NIHR\u2010RP\u20102014\u201004\u2010026"]}],"id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the association between gout severity and socioeconomic status (<jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>) and gout severity and work absence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Postal questionnaires were sent to adult patients who were registered with 20 general practices and who had consultations regarding gout or had been prescribed allopurinol or colchicine in the preceding 2 years. Gout severity was defined using the following proxy measures: number of attacks, history of oligoarticular\/polyarticular attacks, disease duration, and allopurinol use. <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content> was defined using the English index of multiple deprivation (area level) and using self\u2010reported educational attainment (individual level). Work absence was defined as taking time off from work in the past 6 months because of gout. Adjusted odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub>; 95% confidence intervals [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s]) were calculated using logistic regression models (adjusted for age, sex, body mass index, gout severity, and comorbidities).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1,184 completed questionnaires were returned. The mean age of patients was 65.6 years, and 84% were male. Not having attended further education (\u201cfurther education\u201d is defined as attendance after the statutory minimum school\u2010leaving age of 16 years) was associated with having had \u22652 gout attacks in the last year (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub> 0.54 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.36\u20130.81]) and oligoarticular\/polyarticular attacks (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub> 0.72 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.50\u20131.05]). Lower area\u2013level deprivation was associated with fewer attacks (\u22652) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub> 0.71 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.51\u20130.98]). Work absence was associated with having had \u22652 gout attacks in the last year (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub> 2.91 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.22\u2013 6.92]), oligoarticular\/polyarticular attacks (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub> 3.10 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.46\u20136.61]), and shorter disease duration (&gt;18 years) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content><jats:sub>adj<\/jats:sub> 0.13 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.03\u20130.50]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Gout severity was associated with individual\u2010level deprivation, countering the historic and negative perception of gout as a \u201crich man's disease.\u201d The association of gout severity with work absence reinforces the argument for earlier urate\u2010lowering therapy to prevent attacks from becoming frequent and debilitating.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23562","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T14:59:47Z","timestamp":1522076387000},"page":"1822-1828","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Gout Severity, Socioeconomic Status, and Work Absence: A Cross\u2010Sectional Study in Primary Care"],"prefix":"10.1002","volume":"70","author":[{"given":"Zachary","family":"Bowen\u2010Davies","sequence":"first","affiliation":[{"name":"Research Institute for Primary Care &amp; Health Sciences, Keele University UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6645-5751","authenticated-orcid":false,"given":"Sara","family":"Muller","sequence":"additional","affiliation":[{"name":"Research Institute for Primary Care &amp; Health Sciences, Keele University UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian D.","family":"Mallen","sequence":"additional","affiliation":[{"name":"Research Institute for Primary Care &amp; Health Sciences, Keele University UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Hayward","sequence":"additional","affiliation":[{"name":"Research Institute for Primary Care &amp; Health Sciences, Keele University UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Roddy","sequence":"additional","affiliation":[{"name":"Research Institute for Primary Care &amp; Health Sciences, Keele University, Keele UK, and Haywood Academic Rheumatology Centre, Haywood Hospital UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204463"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.23176"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ker361"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-015-0090-9"},{"key":"e_1_2_6_6_1","first-page":"124","article-title":"Inequalities in morbidity and consulting behaviour for socially vulnerable groups","volume":"52","author":"Baker D","year":"2002","journal-title":"Br J Gen Pract"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.06.047"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket262"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150310"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.13006"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-3506(05)80070-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/11.1.71"},{"key":"e_1_2_6_13_1","first-page":"233","article-title":"Severe tophaceous gout. 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