Journal ArticleDOI
Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study
TLDR
A predominantly nurse-led intervention including education, lifestyle advice and ULT can successfully achieve the recommended treatment target in more than 9 out of 10 patients with gout.Abstract:
Introduction Many doctors believe that patients with gout are unwilling to receive urate-lowering therapy (ULT) and blame them for poor adherence to management. Objective To test the effectiveness of a complex intervention for gout that incorporates key elements of current guidelines, including full patient information, delivered in an optimal setting (specialist hospital clinic). Method Observational study of patients reporting ongoing attacks of gout recruited from primary care lists. 106 participants (94 men, 12 women; mean age 61 years) were enrolled in the study. Patients received a predominantly nurse-delivered intervention that included education, individualised lifestyle advice and appropriate ULT. The predefined goal was to achieve serum uric acid (SUA) levels ≤360 μmol/l after 1 year in at least 70% of participants. Results Of the 106 participants at baseline, 16% had tophi; mean (SD) baseline SUA was 456 (98) µmol/l. All participants agreed to joint aspiration to confirm gout and all wished to receive ULT. At 12 months, 92% of the 106 participants had achieved the therapeutic target (SUA≤360 µmol); 85% had SUA Conclusion A predominantly nurse-led intervention including education, lifestyle advice and ULT can successfully achieve the recommended treatment target in more than 9 out of 10 patients. Full explanation and discussion about the nature of gout and its treatment options and individualisation of management probably account for this success.read more
Citations
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Journal ArticleDOI
2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia
Dinesh Khanna,John FitzGerald,Puja P. Khanna,Sangmee Bae,Manjit K. Singh,Tuhina Neogi,Michael H. Pillinger,Joan Merill,Susan J. Lee,Shraddha Prakash,Marian Kaldas,Maneesh Gogia,Fernando Perez-Ruiz,William J. Taylor,Frédéric Lioté,Hyon K. Choi,Jasvinder A. Singh,Nicola Dalbeth,Sanford Kaplan,Vandana Dua Niyyar,Danielle Jones,Steven A. Yarows,Blake J. Roessler,Gail S. Kerr,Charles H. King,Gerald Levy,Daniel E. Furst,N. Lawrence Edwards,Brian F. Mandell,H. Ralph Schumacher,Mark L. Robbins,Neil S. Wenger,Robert Terkeltaub +32 more
TL;DR: DINESH KHanNA, JOHN D. FITZGERALD, PUJA P. KHANNA, SANGMEE BAE, MANJIT K. SINGH, TUHINA NEOGI, MICHAEL H. PILLINGER, JOAN MERILL, SUSAN LEE, SHRADDHA PRAKASH, MARIAN KALDAS, MANEESH GOGIA, FERNANDO PEREZ-RUI
Journal ArticleDOI
2016 updated EULAR evidence-based recommendations for the management of gout
Pascal Richette,Michael Doherty,Eliseo Pascual,V. Barskova,Fabio Becce,Johann Castañeda-Sanabria,M. Coyfish,S Guillo,T.L.Th.A. Jansen,Hein J.E.M. Janssens,Frédéric Lioté,Christian D Mallen,George Nuki,Fernando Perez-Ruiz,J. Pimentao,Leonardo Punzi,T Pywell,Alexander So,Anne-Kathrin Tausche,Till Uhlig,Jakub Zavada,Weiya Zhang,Florence Tubach,Thomas Bardin +23 more
TL;DR: In addition to education and a non-pharmacological management approach, urate-lowering therapy (ULT) should be considered from the first presentation of the disease, and serum uric acid (SUA) levels should be maintained at the predefined urate target to cure the disease.
Journal ArticleDOI
2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis.
Dinesh Khanna,Puja P. Khanna,John FitzGerald,Manjit K. Singh,Sangmee Bae,Tuhina Neogi,Michael H. Pillinger,Joan Merill,Susan J. Lee,Shraddha Prakash,Marian Kaldas,Maneesh Gogia,Fernando Perez-Ruiz,William J. Taylor,Frédéric Lioté,Hyon K. Choi,Jasvinder A. Singh,Nicola Dalbeth,Sanford Kaplan,Vandana Dua Niyyar,Danielle Jones,Steven A. Yarows,Blake J. Roessler,Gail S. Kerr,Charles H. King,Gerald Levy,Daniel E. Furst,N. Lawrence Edwards,Brian F. Mandell,H. Ralph Schumacher,Mark L. Robbins,Neil S. Wenger,Robert Terkeltaub +32 more
TL;DR: These guidelines for the management and anti-inflammatory prophylaxis of acute attacks of gouty arthritis complements the manuscript on guidelines to treat hyperuricemia in patients with evidence of gouts and involves a diverse and international panel of experts.
Journal ArticleDOI
Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study
TL;DR: Trends in the epidemiology of gout and patterns of urate-lowering treatment (ULT) in the UK general population from 1997 to 2012 are described and patient adherence has improved during the study period, but it remains poor.
References
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EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee For International Clinical Studies Including Therapeutics (ESCISIT)
Weiya Zhang,M. Doherty,Thomas Bardin,Eliseo Pascual,V. Barskova,P.G. Conaghan,J Gerster,J Jacobs,Burkhard F. Leeb,Frédéric Lioté,Geraldine M. McCarthy,Patrick Netter,George Nuki,Fernando Perez-Ruiz,A Pignone,J. Pimentao,Leonardo Punzi,Edward Roddy,Till Uhlig,Irena Zimmermann-Górska +19 more
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Comparison of drug adherence rates among patients with seven different medical conditions.
TL;DR: To compare drug adherence rates among patients with gout, hypercholesterolemia, hypertension, hypothyroidism, osteoporosis, seizure disorders, and type 2 diabetes mellitus by using a standardized approach.
Journal ArticleDOI
British Society for Rheumatology and British Health Professionals in Rheumatology Guideline for the Management of Gout
K M Jordan,J. Stewart Cameron,Michael Snaith,Weiya Zhang,Michael Doherty,Jonathan Seckl,Aroon D. Hingorani,Richard Jaques +7 more
TL;DR: Evidence-based guidelines are needed for gout management and prevention based on expert consensus rather than research evidence and audits of practice suggest that treatment is very variable.
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Gout in the UK and Germany : prevalence, comorbidities and management in general practice 2000-2005
Lieven Annemans,E Spaepen,Marion M. Gaskin,Mireille M. Bonnemaire,V. V. Malier,Thomas W. Gilbert,George Nuki +6 more
TL;DR: The importance of regular monitoring of sUA in order to tailor gout treatment was highlighted by data from this study showing that patients with sUA levels ⩾360 μmol/l (⩾6 mg/dl) had an increased risk of gout flares.
Related Papers (5)
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