ABSTRACT
INTRODUCTION: The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages. METHODS: Translation and cross-cultural adaptation has been carried out following the forward-backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included. RESULTS: The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option 'not applicable' was added to two items of the ASAS HI to improve appropriateness. DISCUSSION: This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures.
ABSTRACT
OBJECTIVE: To increase the knowledge of epidemiology and treatment of gout in a 'real-life' setting, we conducted a large observational analysis (CACTUS) in two European countries, namely France and Greece. PATIENTS AND METHODS: This was a multicenter, cross-sectional, observational analysis, conducted in France and Greece. The analysis was conducted in a field-practice scenario, with both general practitioners and rheumatologists recruiting patients for inclusion. Treatment methods and drug prescriptions were left to the sole initiative of the participating physicians. A number of epidemiological and clinical characteristics were recorded in a single inclusion visit. Compliance to maintenance treatment was also monitored after the inclusion visit by monthly interview. RESULTS: In total 3079 patients were included. Hypertension was the most common co-morbidity (68%), followed by hypercholesterolemia (59%) and obesity (48%). Mean serum Uric Acid (sUA) concentration was 8.7 mg/dl. Almost all patients received life-style or dietary recommendations. At inclusion, 81.5% of patients were on a urate-lowering treatment. Most of these patients had been treated with allopurinol; this treat-ment had been interrupted for lack of reduction of sUA levels below 6 mg/dl (47%), lack of symptom relief (34%) or poor compliance (23%). At the inclusion visit, 98% of the patients were prescribed an urate-lowering treatment: 87% received febuxostat and 12% allopurinol alone. Satisfactory or very satisfactory compliance to febuxostat was recorded in 92% of the patients, versus 82% in patients on allopurinol. CONCLUSIONS: CACTUS provides an overview of characteristics of gouty patients and gout management. Education of patients by healthcare providers seem to be a pre-requisite to optimize the management of gout, a condition which remains poorly man-aged.
