A recent survey of Europeans with gout offers a startling reminder that stigma can have real medical consequences.
The 15-minute online questionnaire, developed by Grünenthal, found that European patients would rather suffer through debilitating pain caused by gout than seek medical care. Gout is a common and extremely painful form of arthritis caused by uric acid build-up in the joints. The good news is that gout is easily treatable. The bad news is that the condition remains poorly managed across Europe, begging the question “Why?”
In a word: stigma. Patients often avoid seeking medical treatment out of embarrassment. This embarrassment likely stems from a historic association of gout with an overly-indulgent lifestyle and diet. While certain foods, such as alcohol, sugary drinks and meat, can increase the risk of gout, the belief that poor diet causes gout is largely unfounded. Research has shown that the condition is primarily determined by genetics.
Those suffering from gout are not alone. People across Europe with stigmatised diseases are not receiving the care they need. For example, many European countries report stigma and discrimination as barriers to the uptake of HIV prevention and testing services as well as a contributing factor to late diagnosis of HIV.
Similarly, people with migraine often fear that their complaints of pain will not be trusted. With no empirical test for migraine, those who living with the disease often face incredulous speculation from friends, family and coworkers. People may remain in pain rather than seek medical treatment and adequate work-related adjustments. As a result, many people with migraine lead far less productive lives than they could. Economically, the societal burden of migraine in Europe is roughly €27 billion per year.
Ironically, researchers and scientists across Europe work tirelessly to develop innovative, life-changing treatments such as the ones used to treat gout, HIV and migraine. A generation ago, for example, doctors could offer migraine patients only fleeting relief from disease symptoms. Today, advancements in neurotoxins and CGRP inhibitors allow for dramatic reduction in symptoms and can even prevent migraines from happening. Similarly, patients with gout now have uric acid-lowering medications to manage their disease, and even targeted therapies for treatment-resistant gout.
There is a painful irony in watching people struggle with diseases for which effective and long-awaited treatments now exist. For patients across Europe to benefit from innovation and take control of their disease, one final step seems necessary – overcoming stigma.