Abhishek A., Jenkins W., Doherty M.
Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham NG5 1PB, UK.
Background: Poor persistence on urate lowering treatment (ULT) contributes to suboptimal gout management. Previous research from Nottingham, UK demonstrated that gout management comprising of individually targeted patient information and pharmacological treatment as per UK recommendations resulted in >90% patients persisting on ULT at 12 months . The long-term benefit from receiving such an individualised gout treatment after the responsibility of gout management is transferred to the patients’ General Practitioner has not been examined before.
Objectives: To examine persistence on ULT, and serum uric acid (SUA) in participants of the proof of concept study at 5 years .
Methods: 100 of the 106 gout patients treated in the proof of concept study (died 5, moved out of area 1) were mailed a questionnaire that elicited information about their current ULT, compliance on ULT, reason ULT discontinued (if applicable) and number of acute attacks of gout in the previous 12 months. Participants were invited for a visit at which height, weight, and blood pressure were measured, musculoskeletal examination performed and peripheral blood collected.
Results: Seventy-five questionnaires were returned. Their mean (standard deviation) age, body mass index, and serum uric acid (SUA) were 68.07(10.12) years, 30.40(4.71) kg/m2, and 294.73(97.89) µmol/L respectively. Sixty-eight (91%) patients were currently on ULT. The reasons for ULT discontinuation were lack of gout symptoms (3), not keen on medications (2), temporary discontinuation due to unrelated haematological abnormality (1), and not-specified (1). SUA was measured in 65 patients. Of these, the SUA was <300, 301-360, and >360 µmol/L in 68.3%, 17.5%, and 14.3% participants.
Discussion: This study provides data that patients with gout adhere to ULT with over 85% patients meeting the target SUA recommended by EULAR at 5 years, even after the responsibility of prescribing ULT is handed back to their GP provided they are fully informed about the disease and its management at the beginning of treatment.
References: 1. Rees, F., W. Jenkins, and M. Doherty, Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann Rheum Dis, 2013. 72(6): p. 826-30.