Gout Flare, Pain are Primary Motivators for Seeking Reactive Care

An analysis of gout social media posts revealed that flares, pain, swelling, and concerns regarding uric acid were the primary motivating factors for patients seeking gout care, according to data presented at the European Congress of Rheumatology (EULAR) 2023.1 Posts mentioning the word “pain” were twice as likely to also mention reactive care when compared with proactive gout conversations.

Daniel Hernandez, MD

Credit: CreakyJoints.org

Further, reactive care conversations were more likely to be more negative, which indicated proactive management is potentially overall more beneficial for this population. Investigators emphasized information gathered in the analysis can be used to both identify and address areas of concerns or dissatisfaction.

“To understand the needs of a particular community, it is imperative to actively listen to and interpret the patient experience,” wrote Maria Picone, Founder and CEO of the TREND Community, an organization whose proprietary technology gleans patient community insights through social listening.

Gout, a common form of inflammatory arthritis is a chronic condition in which patients experience symptoms of pain, swelling, redness, and heat in one joint, most likely in the big toe. The condition is caused by hyperuricemia, defined as an excess of uric acid in the body.²

The management of gout is characterized by either proactive or reactive treatment. Proactive management includes prophylactic care, such as treating underlying illness and scheduling regular doctor visits, while reactive management is spontaneous care driven by symptom onset. According to investigators, the ideal management strategy is debated; however, the American College of Physicians recommends a “treat-to-symptom control” strategy.

The study aimed to identify the gout symptoms most associated with reactive disease management as well as evaluate the sentiment of patients with gout when describing proactive vs reactive therapeutic experiences. A proprietary artificial intelligence (AI) analytics engine was utilized to assess social media conversations in 2 social media sources: a public subreddit (r/gout) with over 9000 members and 125,000 posts/comments, and a private Facebook group (The Gout Support Group of America) with over 1000 members and 50,000 posts/comments.

AI identified all posts and comments discussing either proactive or reactive care experiences and entity recognition was used to find the most frequently mentioned clinical findings by care type. A pretrained sentiment tagger was used to categorize the general sentiment of the conversations.

In both proactive and reactive conversations, the most frequently mentioned keywords were “flares,” “uric acid,” “pain,” and “swelling.” However, within the reactive care gout conversations (n = 1253 posts/comments from 624 users), “pain” and “swelling” were significantly more likely to be mentioned and “uric acid” was significantly less likely when compared with proactive care conversations (n = 1205 posts/comments from 521 users).

The mention of flares did not significantly impact the probability of mentioning either care type. Analysis showed reactive care statements had a significantly lower mean sentiment score, which indicated a more negative response when compared with proactive care.

Investigators noted future research should continue to explore patient-reported experiences and perspectives to better understand and guide care-based gout treatment and management decisions.

“By analyzing social media conversations, we have the potential to take the pulse of patient cohorts in real time, which can help us understand their experiences and needs better,” wrote Daniel Hernandez, MD, Director, Medical Affairs and Hispanic Outreach, Global Healthy Living Foundation. “The possibilities of this in healthcare are vast, and we are excited to collaborate in significantly contributing to improving patient care, communication, and disease management.”

References

1. ^{M Flurie, M Converse, K Davidson, D Hernandez, et al. Using Social Media Conversations to Understand Patient Care: Factors Driving Proactive vs Reactive Management of Gout. Paper presented at: European Congress of Rheumatology (EULAR) 2023. Milan, Italy. May 31 – June 3, 2023.}
2. ^{Centers for Disease Control and Prevention. (2020, July 27). Gout. Centers for Disease Control and Prevention. Accessed June 1, 2023. https://www.cdc.gov/arthritis/basics/gout.html#:~:text=quality%20of%20life%3F-,What%20is%20gout%3F,no%20symptoms%2C%20known%20as%20remission.}