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. 2013 Sep;52(9):1623-9.
doi: 10.1093/rheumatology/ket158. Epub 2013 Apr 25.

Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire

Leslie R Harrold  1 , Kathleen M Mazor, Amarie Negron, Jessica Ogarek, Cassandra Firneno, Robert A Yood
Affiliations

Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire

Leslie R Harrold et al. Rheumatology (Oxford). 2013 Sep.

Abstract

Objective: We sought to examine primary care providers' gout knowledge and reported treatment patterns in comparison with current treatment recommendations.

Methods: We conducted a national survey of a random sample of US primary care physicians to assess their treatment of acute, intercritical and tophaceous gout using published European and American gout treatment recommendations and guidelines as a gold standard.

Results: There were 838 respondents (response rate of 41%), most of whom worked in private practice (63%) with >16 years experience (52%). Inappropriate dosing of medications in the setting of renal disease and lack of prophylaxis when initiating urate-lowering therapy (ULT) accounted for much of the lack of compliance with treatment recommendations. Specifically for acute podagra, 53% reported avoidance of anti-inflammatory drugs in the setting of renal insufficiency, use of colchicine at a dose of ≤2.4 mg/day and no initiation of a ULT during an acute attack. For intercritical gout in the setting of renal disease, 3% would provide care consistent with the recommendations, including initiating a ULT at the appropriate dose with dosing titration to a serum urate level of ≤6 mg/dl and providing prophylaxis. For tophaceous gout, 17% reported care consistent with the recommendations, including ULT use with dosing titration to a serum urate level of ≤6 mg/dl and prophylaxis.

Conclusion: Only half of primary care providers reported optimal treatment practices for the management of acute gout and <20% for intercritical or tophaceous gout, suggesting that care deficiencies are common.

Keywords: gout knowledge; medication use; treatment practices.

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