Tags

Type your tag names separated by a space and hit enter

Better outcomes for patients with gout.
Inflammopharmacology. 2020 Oct; 28(5):1395-1400.I

Abstract

Gout is increasing in prevalence despite effective pharmacotherapies. Barriers to effective management are largely educational deficiencies. Sufferers, usually men, need to understand more about gout, especially that maintaining serum urate below 0.36 mmol/L will eliminate recurrent attacks. Also, of great importance is appreciating that sub-optimal adherence to urate-lowering therapy (ULT) will result in a return of attacks. Prescribers also need to understand that acute attacks are likely to occur in the first few months of urate-lowering therapy (ULT), but these can be mitigated by commencing with a dose of ULT reflective of renal function and escalating the dose slowly, every 2-5 weeks until target serum urate is achieved. Prophylaxis against acute attacks over the initial 6 months period of ULT can be enhanced further with concomitant colchicine or nonsteroidal anti-inflammatory drugs (NSAIDs).Gout is largely managed in primary care. Rates of adherence to ULT are 50% or less, worse than most other chronic illnesses. Efforts at educating primary care physicians to, firstly, manage gout effectively and, secondly, to educate their gout patients sufficiently have not been successful. Allied health practitioners, such as nurses, working with prescribers in primary care settings and given the mandate to educate and manage patients with gout, have been spectacularly effective. However, this approach is resource intensive. 'Personalised' eHealth interventions show promise as an alternative strategy, notably in improving adherence to ULT.Numerous applications for smart phones (apps) are now available to assist people with chronic health conditions. Their design needs to accommodate the barriers and enablers perceived by patients to maintaining adherence to prescribed therapies. Personalised feedback of serum urate may represent an important enabler of adherence to ULT in the case of gout.Harnessing mobile apps to support patients managing their chronic illnesses represents an important opportunity to enhance health outcomes. Rigorous, patient-centred and driven development is critical. These tools also require careful evaluation for effectiveness.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Day R
St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia. r.day@unsw.edu.au. Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia. r.day@unsw.edu.au.
Nguyen A
St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia. Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia.
Graham G
Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia. School of Medical Science, Department of Pharmacology, UNSW Medicine, Sydney, Australia.
Aung E
St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia. Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia.
Coleshill M
St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia. Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia.
Stocker S
St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, Australia. Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia.

MeSH

Anti-Inflammatory Agents, Non-SteroidalColchicineDose-Response Relationship, DrugDrug Therapy, CombinationGoutGout SuppressantsHumansMedication AdherenceMobile ApplicationsUric Acid

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32095979

Citation

Day, Richard, et al. "Better Outcomes for Patients With Gout." Inflammopharmacology, vol. 28, no. 5, 2020, pp. 1395-1400.
Day R, Nguyen A, Graham G, et al. Better outcomes for patients with gout. Inflammopharmacology. 2020;28(5):1395-1400.
Day, R., Nguyen, A., Graham, G., Aung, E., Coleshill, M., & Stocker, S. (2020). Better outcomes for patients with gout. Inflammopharmacology, 28(5), 1395-1400. https://doi.org/10.1007/s10787-020-00694-7
Day R, et al. Better Outcomes for Patients With Gout. Inflammopharmacology. 2020;28(5):1395-1400. PubMed PMID: 32095979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Better outcomes for patients with gout. AU - Day,Richard, AU - Nguyen,Amy, AU - Graham,Garry, AU - Aung,Eindra, AU - Coleshill,Mathew, AU - Stocker,Sophie, Y1 - 2020/02/25/ PY - 2020/01/27/received PY - 2020/02/11/accepted PY - 2020/2/26/pubmed PY - 2021/7/2/medline PY - 2020/2/26/entrez KW - Adherence KW - Allopurinol KW - Barriers KW - Dose–response KW - Enablers KW - Gout SP - 1395 EP - 1400 JF - Inflammopharmacology JO - Inflammopharmacology VL - 28 IS - 5 N2 - Gout is increasing in prevalence despite effective pharmacotherapies. Barriers to effective management are largely educational deficiencies. Sufferers, usually men, need to understand more about gout, especially that maintaining serum urate below 0.36 mmol/L will eliminate recurrent attacks. Also, of great importance is appreciating that sub-optimal adherence to urate-lowering therapy (ULT) will result in a return of attacks. Prescribers also need to understand that acute attacks are likely to occur in the first few months of urate-lowering therapy (ULT), but these can be mitigated by commencing with a dose of ULT reflective of renal function and escalating the dose slowly, every 2-5 weeks until target serum urate is achieved. Prophylaxis against acute attacks over the initial 6 months period of ULT can be enhanced further with concomitant colchicine or nonsteroidal anti-inflammatory drugs (NSAIDs).Gout is largely managed in primary care. Rates of adherence to ULT are 50% or less, worse than most other chronic illnesses. Efforts at educating primary care physicians to, firstly, manage gout effectively and, secondly, to educate their gout patients sufficiently have not been successful. Allied health practitioners, such as nurses, working with prescribers in primary care settings and given the mandate to educate and manage patients with gout, have been spectacularly effective. However, this approach is resource intensive. 'Personalised' eHealth interventions show promise as an alternative strategy, notably in improving adherence to ULT.Numerous applications for smart phones (apps) are now available to assist people with chronic health conditions. Their design needs to accommodate the barriers and enablers perceived by patients to maintaining adherence to prescribed therapies. Personalised feedback of serum urate may represent an important enabler of adherence to ULT in the case of gout.Harnessing mobile apps to support patients managing their chronic illnesses represents an important opportunity to enhance health outcomes. Rigorous, patient-centred and driven development is critical. These tools also require careful evaluation for effectiveness. SN - 1568-5608 UR - https://www.unboundmedicine.com/medline/citation/32095979/Better_outcomes_for_patients_with_gout_ DB - PRIME DP - Unbound Medicine ER -