Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire
Meyers Primary Care Institute; Department of Medicine, Division of Rheumatology; Department of Orthopedics and Physical Rehabilitation
Medical Subject Headings
Gout; Primary Health Care
Clinical Epidemiology | Health Services Research | Musculoskeletal Diseases | Primary Care | Rheumatology
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
Gout knowledge, Medication use, Treatment practices
Harrold, Leslie R.; Mazor, Kathleen M.; Negron, Amarie; Ogarek, Jessica; Firneno, Cassandra L.; and Yood, Robert A., "Primary care providers' knowledge, beliefs and treatment practices for gout: results of a physician questionnaire" (2013). Meyers Primary Care Institute Publications and Presentations. 651.