Compliance of Primary Care Providers With Gout Treatment Recommendations-Lessons to Learn: Results of a Nationwide Survey.

Judith Sautner,Thomas Sautner

doi:10.3389/fmed.2020.00244

Abstract

Objectives: Gout is generally managed in the primary health care sector. Compliance of primary care physicians with gout management recommendations has been shown to be insufficient in the past. The primary aims of this study were to assess primary care providers' knowledge regarding gout and to determine if their treatment decisions are influenced by recommendations. Facing considerable variations in postgraduate training options in Austria, we secondly looked for possible knowledge differences between urban and rural areas and eastern and western parts of Austria.Methods: We conducted a survey among 343 primary care physicians in Austria, using a questionnaire consisting of 10 questions on acute, intercritical and general gout management. Gout treatment recommendations served as the therapeutic gold standard.Results: Of the 343 physicians surveyed, 336 completed the questionnaire, leading to a very high return rate of 98%. 289 (86%) physicians were aware of the agreed-upon SUA target (<6 mg/dl). 323 (96.1%) reported change of therapy in case of missing this target. 112 (33.3%) physicians voted for long term ULT. No geographical differences in knowledge regarding gout or its management were revealed, except that colchicine was rated as being a safe medication significantly more often in rural areas (p = 0.035) and in western Austria (p = 0.014).Conclusion: As opposed to former studies, gout knowledge among primary care physicians has improved - however, treatment patterns are still not fully concordant with gout recommendations. Our findings may help to better tailor future postgraduate training to improve primary care physicians' education in gout.

Highlights

Gout, with a prevalence of ∼2%, is the leading cause of inflammatory arthritis within developed countries
Self-administered questionnaire, consisting of ten questions to assess clinical knowledge and beliefs and to investigate therapeutic patterns for acute and intercritical gout as well as general gout management
The proportions of participants per province in our sample were similar to the proportions of overall primary care physicians per province in six of the comprised provinces

Summary

Introduction

With a prevalence of ∼2%, is the leading cause of inflammatory arthritis within developed countries. An association between gout and various internal diseases is generally acknowledged [3,4,5,6]. A number of gout recommendations have been established by various rheumatologic societies [10,11,12,13,14,15]. Gout is mainly managed in the primary care sector. Despite the multitude of recommendations available, the standard of gout management is not yet optimal and lags behind the research [16,17,18]. Research, especially in primary care, is proposed [10]

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Discussion

Conclusion