Thoughts about the future and long-term effects of gout

Thoughts about the future

Several people felt positive and optimistic about the way they were managing their gout, and did not anticipate any future problems. Jeff felt that it was no problem to live with gout once it was controlled by medication. Ivor felt that gout would not impact on his future because he knew how to manage his attacks effectively. Harry had noticed dramatic improvements in his symptoms since he had been taking daily preventative medication (febuxostat). He no longer had attacks and the swelling in his joints had gone down. He hoped that things would continue to improve but felt that, as long as the medication continued to be effective, he no longer needed to think of himself as having gout.

Tony felt that gout did not affect his life now. If things changed in the future, he might need daily preventative medication.

Age at interview 65

Gender Male

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Other people hoped that recent changes they had made (e.g. starting daily preventative medication) would mean they did not get attacks again. Janette felt that she had ‘beaten’ gout and was sure that she would not get another attack. A few people wondered if their daily medication would continue to be as effective in preventing attacks in the future. Others hoped that new treatments for gout would be developed in the future as alternative options. Several people had no concerns about the future because they believed that their medication would continue to be effective in preventing attacks and long-term damage.

Ian feels that allopurinol has been very effective for him. Gout no longer affects his everyday life.

Gender Male

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Some people thought that ongoing preventative medication might be an option for them in the future if their attacks became more frequent or were having a bigger impact on their lives. Arthur was keen to get his gout controlled in the future.

Getting older has made Arthur more determined to get his gout controlled so that it does not impact his leisure and social activities.

Age at interview 63

Gender Male

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Gerald found it hard to think about the future because a future with gout looked difficult. He was only just starting to look ahead, and was hopeful that his doctors would work out how to control his gout and ease the pain. Eddie felt that he had learnt to accept having gout, and did not think that his attacks would stop completely in the future. Paula felt concerned about what would happen if her kidney function got worse, but she was aware that there were drugs available that could help.

Eddie worries about losing his independence if his attacks get more frequent as he gets older.

Gender Male

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Some people worried that gout might affect them more in the future in terms of the frequency or intensity of attacks – particularly when relatives or friends with gout had been severely affected by it. In contrast, Dee did not feel worried about the future because she saw her mother managing her gout well as she grew older. A few people wondered whether their children would get gout in the future. Hazel was worried about how to manage gout in the future, including when starting a family. John was glad to know that he had close family who would be around to give him support if he needed it in the future.

Thoughts about long-term effects

Many people did not know that if their uric acid levels remained high, they were at risk of long-term joint damage and other problems, such as kidney stones. Daily medication (e.g. allopurinol) lowers uric acid levels to prevent attacks and long-term problems. Other people worried about developing tophi (small white lumps of uric acid) under their skin if their uric acid levels were high. (For more see ‘Long-term treatment to lower uric acid and prevent gout attacks and long-term problems‘).

Harry did not realise that gout was causing him long-term joint damage. He now takes febuxostat every day and has noticed improvements in some joints.

Age at interview 78

Gender Male

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There are no known unwanted side effects in later life for people who take long-term allopurinol, but many people were worried about this – particularly if they started taking it at a young age. Jonathan wondered about effects on liver function. Others, like Jeff, were not worried about taking daily medication. Some wanted more monitoring to make sure that gout, and/or their medication, were not causing any other problems (for more see ‘Monitoring gout‘).

Sue thought that too much information about potential long-term problems could be frightening. She preferred to ask her GP if she wanted information rather than looking on the internet.

Sam would have liked the opportunity to discuss possible long-term effects with her doctor.

Age at interview 41

Gender Female

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Other people wanted to know whether having gout meant they were more likely to get other forms of arthritis when they were older. High uric acid levels can lead to long-term joint damage, but with the right treatment this can be prevented for most people. People with gout are sometimes more likely to also have other forms of arthritis, but there is no evidence that gout causes this.

Ian wondered if his gout was caused because his kidneys were less effective at removing uric acid, and whether this could lead to other kidney-related problems later in life.

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