Background
Methods
Standards, criteria and targets
Theme of care | Guideline statement | Criteria | Standards |
---|---|---|---|
Assessment of gout patients | All patients presenting with acute gout should have SUA, renal function and glucose assessed 4-6wk after acute attack [3] | 1.1 Adult patients with a diagnosis of gout have ever had a recorded SUA | ≥90% |
1.2 Adult patients with a diagnosis of gout have ever had a recorded eGFR | ≥90% | ||
1.3 Adult patients with a diagnosis of gout have had a recorded serum glucose since diagnosis | ≥90% | ||
Management of recurrent gout | The therapeutic goal of urate lowering therapy…is achieved by maintaining the SUA below the saturation point for urate (≤360 μmol/l) [4] | 2.1 Adult patients currently prescribed (prescription in the last 2 months) allopurinol have a SUA measured in the last year | ≥90% |
2.2 Adult patients currently prescribed (prescription in the last 2 months) allopurinol have an SUA ≤ 360 μmol/l | ≥80% | ||
Monitoring of gout patients | Annual measurements of plasma renal function and SUA [3] | 3.1 Adult patients with a diagnosis of gout have had a SUA in the last year | ≥90% |
3.2 Adult patients with a diagnosis of gout have had a eGFR measured in the last year | ≥90% | ||
Lifestyle advice | 4.1 Adult patients with a diagnosis of gout with evidence of advice regarding diet recorded | ≥90% | |
[It is recognised that such information may be provided in written format in a patient information leaflet] | 4.2 Adult patients with a diagnosis of gout with evidence of advice regarding alcohol recorded | ≥90% | |
4.3 Adult patients with a diagnosis of gout with evidence of advice regarding fluid intake recorded | ≥90% | ||
4.4 Adult patients with a diagnosis of gout have a record of BMI | ≥90% | ||
Addressing comorbidities | Associated comorbidities and cardiovascular risk factors should be addressed as an important part of the management of gout [4] | 5.1 Adult patients with a diagnosis of gout have a recorded CVD risk assessment score | ≥90% |
5.2 Adult patients with a diagnosis of gout and a 10 yr risk of CVD ≥20% are prescribed lipid lowering therapy | ≥75% | ||
5.3 Adult patients with a diagnosis of gout currently taking diuretics | <25% |
Inclusion criteria
Search strategy
Data extraction and analysis
Results
Characteristic | |
---|---|
Mean age (median, IQR) | 65.5 years (67.0 years, 54.5-77.0) |
Gender male, n(%) | 227 (74%) |
Mean duration since first electronic diagnosis of gout (median, IQR) | 8.5 years (6.4 years, 1.4-13.0) |
Proportion currently taking ULT, n(%) | 77 (25%) |
Assessment of all gout patients
Criterion | Standard | Attainment (n = 305) | |
---|---|---|---|
1.1 Adult patients with a diagnosis of gout have ever had a recorded SUA | ≥90% | 226 (74%) | |
1.2 Adult patients with a diagnosis of gout have ever had a recorded eGFR | ≥90% | 34 (11%) | |
1.3 Adult patients with a diagnosis of gout have had a recorded serum glucose since diagnosis | ≥90% | 162 (53%) | |
2.1 Adult patients currently prescribed (prescription in the last 2 months) allopurinol have a SUA in the last year | ≥90% | 26 (34%) | |
2.2 Adult patients currently prescribed (prescription in the last 2 months) allopurinol have an SUA of ≤360 μmol/l | ≥80% | 29 (38%) | |
3.1 Adult patients with a diagnosis of gout have a SUA in the last year | ≥90% | 68 (22%) | |
3.2 Adult patients with a diagnosis of gout have had an eGFR in the last year | ≥90% | 27 (9%) | |
4.1 Adult patients with a diagnosis of gout with evidence of advice regarding diet recorded | >50% | Diet discussed | 43 (14%) |
4.2 Adult patients with a diagnosis of gout with evidence of advice regarding alcohol recorded | >50% | Alcohol intake discussed | 18 (6%) |
Alcohol type discussed | 9 (3%) | ||
Advised about alcohol intake | 17 (6%) | ||
4.3 Adult patients with a diagnosis of gout with evidence of advice regarding fluid intake recorded | >50% | Maintain fluid intake 2 L/day | 42 (14%) |
4.4 Adult patients with a diagnosis of gout have a record of BMI | ≥90% | BMI documented | 304 (100%) |
-- | -- | 'Lifestyle advice’ documented | 7 (2%) |
-- | -- | PIL given | 11 (4%) |
5.1 Adult patients with a diagnosis of gout have a recorded CVD risk assessment score | ≥90% | 305 | 105 (34%) |
5.2 Adult patients with a diagnosis of gout and a 10 yr risk of CVD ≥20% are prescribed lipid lowering therapy | ≥75% | 56 | 30 (54%) |
5.3 Adult patients with a diagnosis of gout currently taking diuretics | <25% | 73 (24%) |