Do you know more than your doctor about gout?

[Keith Taylor]

I just saw a survey of gout management knowledge in new medical graduates[*]. Or, rather, I’ve seen the results, but I’m still looking for the actual survey.

Anyway, I think it’s fairly easy to work out the questions from the results:

Most (81.1%) felt that gout was a serious disease, 51.2% answered that they had been taught adequately to manage acute gout, only 37.2% for chronic gout. In an acute gout flare, 63.4% answered they would continue urate lowering therapy and 67.2% were aware of first-line pharmacological management options; 28% answered the correct dosing regimen for colchicine. Chronic management was answered poorly. Only 42.0% stated they would titrate allopurinol dosing to a target urate level; 23.5% would check the urate level monthly. More than half, 56.8%, were aware that medical prophylaxis is indicated when initiating urate lowering therapy. Of this subgroup, 46.7% (25.9% overall) knew that non-steroidal anti-inflammatory drugs and colchicine were recommended and 28.4% (15.4% overall) answered the correct timeframe of use. Close to one-third (35.0%), were aware of febuxostat, probenecid and benzbromarone as second-line urate lowering therapy.

Which leads to the expected conclusion:

The findings of this study suggest that new graduates’ knowledge of gout management, especially chronic management, is suboptimal. Many felt their teaching on gout management inadequate; this is a potential target for intervention. Up to date university education which covers chronic management may lead to better clinical outcomes for this burdensome disease.

It would be very interesting to compare this to different countries. But, more interesting to compare it to the average doctor who is currently in daily practice.

What are your answers to these crucial aspects of gout management?

Rheumatologist’s Gout Treatment Failure Rates

I found this chart after looking for a suitable image to illustrate this topic. It is not from the gout study that I’ve written about. But, it is relevant as far as suboptimal gout treatment is concerned.

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Gout doctors knowledge references
[*] Terrill, Matthew, and John Riordan. “A survey on the beliefs and knowledge of gout management in new medical graduates; New South Wales, Australia.” International Journal of Rheumatic Diseases (2017).

Also, read my gout doctors articles.

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