A return to normality: A descriptive qualitative interview study exploring the patient experience of gout flare resolution

OBJECTIVES: While the definition of a gout flare is well established, the state of gout flare resolution has not yet been defined. This study aimed to explore patients' experiences and perceptions of gout flare resolution. METHODS: Semi-structured interviews were conducted with 24 people with gout, guided by open-ended questions exploring their experiences of gout flare resolution. To facilitate discussion, participants were shown graphs depicting changes in pain intensity during a hypothetical flare. Prompts relating to key flare features, including pain, swelling, warmth, and medication use, were used as appropriate. Data were analysed using a descriptive approach to thematic analysis to prioritise participants' voices and experiences. RESULTS: Four themes, closely tied to an overarching concept of a return to normality, were generated: (1) return to personal baseline pain - where most participants required a pain score of 0/10, while the remaining considered resolution to occur at low-to-moderate pain levels; (2) return of function; (3) restoration of emotional wellbeing; and (4) disappearance of joint swelling, warmth and redness. CONCLUSIONS: Flare resolution is experienced as a return to normality, encompassing relief from pain, return of mobility, restored wellbeing and the disappearance of other inflammatory features, such as swelling, warmth and redness. Incorporating these insights into the development of a patient-centred definition for flare resolution may support more meaningful, patient-centred approaches to measuring and managing gout flares.