The quality of management of patients with gout in real clinical practice
https://doi.org/10.14412/1996-7012-2019-1-80-85
Abstract
Despite the existing guidelines for the management of gout and its potential reversibility, the quality of patient management in general therapy practice remains a serious issue.
Objective: to assess the current state of management of patients with gout in real clinical practice.
Patients and methods. The first stage of the study included an interview with 97 physicians grouped according to their specialties: rheumatologists, general practitioners, and others. The second stage involved an interview with 64 patients with gout who were followed up by physicians of different specialties.
Results and discussion. Physicians most frequently used nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, glucocorticoids (GCs), and allopurinol. Urate-lowering drugs were prescribed mostly by rheumatologists and more rarely by other specialists. The most commonly used drug was allopurinol at a maximum dose 300 mg/day. There was a tendency to a decrease in the number of tophi in the patients who were treated according to the EULAR (European League Against Rheumatism) guidelines. The patients of this group also had lower levels of uric acid (UA) and were more highly adherent to therapy.
The predominant use of NSAIDs in the rare administration of colchicine and GCs, as well as the use of allopurinol to relieve an acute gout attack creates prerequisites for aggravating the disease and decreasing patient compliance. The insufficient dose of allopurinol and no use of prophylactic colchicine for chronic gout contribute to the progression of the disease and the development of its acute attacks. Following the EULAR guidelines makes it possible to achieve the target levels of UA and not only prevent, but also to ensure the regression of gout manifestations, such as tophi.
Conclusion. For radical improvement of the situation, physicians of all specialties should be regularly trained in the management of patients with gout according to the EULAR guidelines.About the Authors
O. V. Teplyakova
Ural State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Olga Vyacheslavovna Teplyakova
3, Repin St., Yekaterinburg 620028
A. V. Sarapulova
Ural State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
3, Repin St., Yekaterinburg 620028
A. A. Popov
Ural State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
3, Repin St., Yekaterinburg 620028
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For citations:
Teplyakova OV, Sarapulova AV, Popov AA. The quality of management of patients with gout in real clinical practice. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2019;13(1):80-85. (In Russ.) https://doi.org/10.14412/1996-7012-2019-1-80-85
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