Friday, 13 Jul 2018

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Gouts' Increasing Hospitalizations and Poor Management

Numerous studies have shown that gout hospitalizations have increased in the last decade. Also worrisome is a new studiy showing that patients admitted to the hospital are less likely to have received recommended urate-lowering treatment (ULT). (Abstract OP0262 - http://buff.ly/2roN7SF)

Dehlin and Swedish researchers have analyzed the Western Swedish Health Care Region register to identify gout hospitalizations between 2000-2013. They found the annual hospitalization rate for gout increased from 12.2 to 16.7 per 100 000 adults, with a resultant 56% increase in healthcare costs.

Moreover, these patients were less likely to receive ULT -  only 19 to 27% had been on ULT in the 6 months preceding their hospitalization. This considerable lack of treatment is seen as yet another reason for the growth in gout hospitalizations in Sweden.

A second study, examined whether nurse-led management of gout using EULAR guidelines and treat to target principles significantly improved patient outcomes compared to standard general practitioner care (http://buff.ly/2sBCxvY).

Over 2 years, they studied 517 patients who received usual care by general practitioners (GP) or nurse-led care.  Nurse lead care were more likely to achieve SUA targets, more likely to be prescribed ULT (97% vs. 54%), more escalation of  allopurinol therapy (470 vs. 240 mg), fewer gout attacks, and a nearly 75% reduction in tophus size. 

The results of these studies have immediate applicability to gout populations and public welfare and healthcare costs. 

 

 

 

Disclosures: 
The author has received research/grant financial support on this subject

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