Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire
AuthorsHarrold, Leslie R.
Mazor, Kathleen M.
Firneno, Cassandra L.
Yood, Robert A.
UMass Chan AffiliationsDepartment of Orthopedics and Physical Rehabilitation
Department of Medicine, Division of Rheumatology
Meyers Primary Care Institute
Primary Health Care
Health Services Research
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AbstractObjective. 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
Harrold LR, Mazor KM, Negron A, Ogarek J, Firneno C, Yood RA. Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire. Rheumatology (Oxford). 2013 Sep;52(9):1623-9. doi:10.1093/rheumatology/ket158. Link to article on publisher's site