Abstract
To examine the management of gout in general practice in Townsville, Australia, and to explore comorbid conditions in patients with gout. Study will also explore how closely guidelines are being followed in managing gout. Retrospective chart review was conducted from May to November 2014 in three general practices in Townsville. Registers for patients were established by searching “gout” and “gouty arthritis”. Three hundred and twenty-one patients were included in the study after excluding inactive patients, patients below age of 18 and patients with cancer. Main outcome measures were prevalence of comorbidities in gout patients, gout medications and adequate serum urate control (≤0.36 mmol/l). Multivariate logistic regression was used to study the relationship between serum urate level, comorbid conditions and lifestyle factors. Hypertension was the most common comorbid condition with 60.8 % of patients followed by obesity and dyslipidaemia. In terms of medication, 46.7 % of patients were on allopurinol, 12.8 % on indomethacin and 13.4 % on diuretics. Eighty-six percentage of patients had serum urate level (sUA) recorded in the previous year. Of these, 32.2 % had a serum urate level below or equal to 0.36 mmol/l. Moreover, 17.4 % of patients had lifestyle advice documented in chart. Male gender was the most influential factor in having poor uric acid control (p < 0.01), followed by not being on allopurinol (p < 0.01) and patients older than 50 years (p = 0.02). Management of gout in this study sample was not entirely concordant with guidelines. The study also suggests a need for possible tighter monitoring and allopurinol dosing regime in older, male patients.
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Acknowledgments
I would like to thank the practice managers of the three general practices and James Cook University for funding the project and assisting with the development of the project.
Funding
The project was funded by the James Cook University Honours fund.
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Andrew Jeyaruban declares that he has no conflict of interest. Muriel Soden declares that she has no conflict of interest. Sarah Larkins declares that she has no conflict of interest.
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This article does not contain any studies with human participants or animals performed by any of the authors.
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Informed consent was obtained from the practice managers for the project. Project was approved by James Cook University Ethics Committee (Approval number = H5601).
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Jeyaruban, A., Soden, M. & Larkins, S. Prevalence of comorbidities and management of gout in a tropical city in Australia. Rheumatol Int 36, 1753–1758 (2016). https://doi.org/10.1007/s00296-016-3580-6
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DOI: https://doi.org/10.1007/s00296-016-3580-6