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A survey of the assessment and management of gout in general practitioners and medical officers within the Illawarra Network, Australia
Author(s) -
Terrill Matthew,
Riordan John
Publication year - 2017
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12875
Subject(s) - medicine , gout , colchicine , dosing , creatinine
Aim To review the assessment and management of gout by general practitioners ( GP s) and medical officers ( MO s) within the Illawarra Network, Australia. Method A survey was sent to GP s and MO s within the Illawarra Network. Results Of 110 GP s, 45 responded. Of 129 MO s, 42 responded. The overall response was 32.6%. On analysis, 65.1% felt their knowledge of gout to be adequate and 61.6% thought they had been educated well. In acute assessment, 59.1% of GP s responded that the diagnosis of gout best be confirmed with a joint aspiration and 36.4% clinical suspicion. Differing, 85.7% of MO s chose a joint aspiration. In acute management, if colchicine were used, 59.1% of GP s would give 1 mg followed by 0.5 mg an hour later, then 0.5 mg twice daily, compared to 9.5% of MO s, while 20.5% of GP s would use 1 mg twice daily. Chronic management was answered poorly. After an acute attack, urate lowering therapy ( ULT ) would be started 14 days after by 47.7% of GP s, compared to 69.0% of MO s. GP s were more likely to start ULT within 7 days (52.3% vs . 31.0%). With dosing of ULT , 45.3% would treat to target, while 46.5% would dose to the creatinine clearance. Prophylactic therapy with ULT would be started by 81.8%, although only 17.4% would continue it for 3–6 months. Conclusion There is poor adherence to recommended practice for dosing of colchicine in acute gout. Also in the management of chronic gout, in particular, the timing of starting ULT and the use of prophylaxis when initiating ULT.