Gout poorly managed by GPs

Wednesday, 5 Aug 2015

There is widespread under treatment of gout within primary care in Australia, finds new research that also shows a growing prevalence.

The study that looked at GP electronic medical records over a five-year period found that just over half of all patients diagnosed with gout were prescribed the serum urate lowering therapy allopurinol.

Led by Professor Philip Robinson from the Royal Brisbane and Women’s Hospital in Queensland the study also revealed that patients were not getting their serum urate tested as often as recommended by the American College of Rheumatology and primary care gout guidelines.

Furthermore only 22% of patients had a target serum urate concentration of <0.36 mmol/L recorded during the five-year study period.

The proportion of patients who reached target levels decreased as renal function declined, potentially reflecting a fear of increased adverse events the authors suggested in the paper published in the Journal of Rheumatology.

Gout is associated with many significant health problems like high blood pressure, diabetes and obesity, Professor Robinson told the limbic.

Making sure that people take gout seriously and treat it and its associated health conditions was really important, he said.

The prevalence of gout was growing in Australia and was increasingly being recognised as an important health problem.

Figures from the study showed the crude national prevalence of gout in the general practice population was 1.54% and prevalence was 2.67% in men and 0.53% in women.

Professor Robinson said it was important to note that gout was particularly common in elderly men, with the current prevalence rate standing at just over 11% in men older than 85.

Patients may be undertreated because of a perceived unavailability of adequate therapy, fear of medication side effects or poor knowledge of treatments, the study authors suggested.

A further barrier to effective gout management could be the perception by healthcare professionals that gout is a trivial self-inflicted condition that does not require regular therapy beyond treatment of acute attacks.

“Recognition that gout is common and poorly managed is the first step toward improving the quality of care for people with gout,” they said.

The data was also not completely representative of the Australian population as it did not include Tasmania and the Northern Territory, the authors noted.


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