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A survey of current prescribing practices of antiinflammatory and urate-lowering drugs in gouty arthritis.
N Z Med J. 1991 Mar 27; 104(908):115-7.NZ

Abstract

OBJECTIVE

to assess the prescribing habits in late 1988 of rheumatologists (NZR) and a random sample of general practitioners (NZGP) managing gout and hyperuricaemia.

DESIGN

self administered questionnaires containing two demographic questions and 24 items probing the selection and prescription of antirheumatic drugs in patients with acute gout, chronic tophaceous gout and asymptomatic hyperuricaemia were sent to every rheumatologist and a 10% random sample of general practitioners in active practice.

RESULTS

replies were received from 26 of 27 (96%) rheumatologists and 163 of 207 (79%) of general practitioners Rheumatologists were more likely to use indomethacin as the preferred drug for acute gout, and colchicine either alone or as adjunctive therapy for prophylaxis in chronic gout to prevent acute attacks occurring following the introduction of urate lowering agents, although nonsteroidal antiinflammatory drugs (NSAIDs) were more commonly used for this purpose by both groups. Prior to prescribing urate lowering therapy general practitioners were more likely to attempt control of alcohol intake, and rheumatologists more likely to avoid concomitant low dose salicylates. Allopurinol was the preferred hypouricaemic drug, with rheumatologists more likely to prescribe an initial dose of 100 mg daily, and gradually increase the dose according to the serum urate (SeUa). Although a minority of respondents prescribed allopurinol for asymptomatic hyperuricaemia, general practitioners were more likely to do so at a lower level of serum urate.

CONCLUSION

there was a high level of adherence to what is considered optimal contemporary practice, with a number of differences in prescribing habits probably reflecting differences in case selection between patients attending rheumatologists and general practitioners. The data indicates a continuing need for education programmes for both specialists and general practitioners.

Authors+Show Affiliations

Stuart RA
Middlemore Hospital, Auckland.
Gow PJ
No affiliation info available
Bellamy N
No affiliation info available
Campbell J
No affiliation info available
Grigor R
No affiliation info available

MeSH

Acute DiseaseArthritis, GoutyChronic DiseaseEvaluation Studies as TopicFamily PracticeGout SuppressantsHumansPractice Patterns, Physicians'RecurrenceRheumatologySampling StudiesSurveys and QuestionnairesUric Acid

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

2011292

Citation

Stuart, R A., et al. "A Survey of Current Prescribing Practices of Antiinflammatory and Urate-lowering Drugs in Gouty Arthritis." The New Zealand Medical Journal, vol. 104, no. 908, 1991, pp. 115-7.
Stuart RA, Gow PJ, Bellamy N, et al. A survey of current prescribing practices of antiinflammatory and urate-lowering drugs in gouty arthritis. N Z Med J. 1991;104(908):115-7.
Stuart, R. A., Gow, P. J., Bellamy, N., Campbell, J., & Grigor, R. (1991). A survey of current prescribing practices of antiinflammatory and urate-lowering drugs in gouty arthritis. The New Zealand Medical Journal, 104(908), 115-7.
Stuart RA, et al. A Survey of Current Prescribing Practices of Antiinflammatory and Urate-lowering Drugs in Gouty Arthritis. N Z Med J. 1991 Mar 27;104(908):115-7. PubMed PMID: 2011292.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A survey of current prescribing practices of antiinflammatory and urate-lowering drugs in gouty arthritis. AU - Stuart,R A, AU - Gow,P J, AU - Bellamy,N, AU - Campbell,J, AU - Grigor,R, PY - 1991/3/27/pubmed PY - 1991/3/27/medline PY - 1991/3/27/entrez SP - 115 EP - 7 JF - The New Zealand medical journal JO - N Z Med J VL - 104 IS - 908 N2 - OBJECTIVE: to assess the prescribing habits in late 1988 of rheumatologists (NZR) and a random sample of general practitioners (NZGP) managing gout and hyperuricaemia. DESIGN: self administered questionnaires containing two demographic questions and 24 items probing the selection and prescription of antirheumatic drugs in patients with acute gout, chronic tophaceous gout and asymptomatic hyperuricaemia were sent to every rheumatologist and a 10% random sample of general practitioners in active practice. RESULTS: replies were received from 26 of 27 (96%) rheumatologists and 163 of 207 (79%) of general practitioners Rheumatologists were more likely to use indomethacin as the preferred drug for acute gout, and colchicine either alone or as adjunctive therapy for prophylaxis in chronic gout to prevent acute attacks occurring following the introduction of urate lowering agents, although nonsteroidal antiinflammatory drugs (NSAIDs) were more commonly used for this purpose by both groups. Prior to prescribing urate lowering therapy general practitioners were more likely to attempt control of alcohol intake, and rheumatologists more likely to avoid concomitant low dose salicylates. Allopurinol was the preferred hypouricaemic drug, with rheumatologists more likely to prescribe an initial dose of 100 mg daily, and gradually increase the dose according to the serum urate (SeUa). Although a minority of respondents prescribed allopurinol for asymptomatic hyperuricaemia, general practitioners were more likely to do so at a lower level of serum urate. CONCLUSION: there was a high level of adherence to what is considered optimal contemporary practice, with a number of differences in prescribing habits probably reflecting differences in case selection between patients attending rheumatologists and general practitioners. The data indicates a continuing need for education programmes for both specialists and general practitioners. SN - 0028-8446 UR - https://www.unboundmedicine.com/medline/citation/2011292/A_survey_of_current_prescribing_practices_of_antiinflammatory_and_urate_lowering_drugs_in_gouty_arthritis_ DB - PRIME DP - Unbound Medicine ER -