Abstract

BackgroundGout is an increasingly prevalent form of inflammatory arthritis. Although effective treatments for gout exist, current management is suboptimal due to low medication adherence rates and treatments that are non-concordant with guidelines. Medications are the mainstay and most effective form of gout management. Thus, there is potential for community pharmacists to play an important primary health care role in gout management, however their current role and their potential to improve management of gout treatment is currently unclear. The purpose of the study is to explore the views of Australian pharmacists on their roles in gout management and to identify factors influencing their involvement in gout management.MethodsA convenience sample of community pharmacists were invited to participate using a snowballing recruitment strategy. Semi-structured, face-to-face interviews were conducted with 15 pharmacists of varying age, gender and pharmacy experience. Interviews focused on pharmacists’ experiences of managing gout, interactions with people living with gout and their perceived roles and responsibilities in gout management. Interviews were transcribed verbatim and independently analysed by two reviewers to identify themes.ResultsThe main role of pharmacists reported in gout management was providing patient education. The greatest facilitator to pharmacists involvement in gout management was identified to be pharmacists’ good understanding of gout and its management. Barriers to pharmacists involvement were identified to be difficulties in monitoring adherence to gout medications, low priority given to gout in the pharmacy compared to other chronic health conditions, and lack of specific training and/or continuing education in gout prevention and management.ConclusionsPharmacists can expand their primary health care role in gout management, particularly in the area of ongoing provision of education to people living with gout and in monitoring medication adherence in patients. However, a number of barriers need to be overcome including difficulties in monitoring patient adherence to medications, ensuring a higher priority is given to chronic gout management and providing continuing training to community pharmacists about gout. Implications for pharmacist practice include initiating conversations about medication adherence and education when dispensing medications and undertaking continuing education in gout.

Highlights

  • Gout is an increasingly prevalent form of inflammatory arthritis

  • The aim of this study was to explore the current role of Australian community pharmacists in gout management and to identify any perceived facilitators or barriers to community pharmacists in managing, monitoring and treating people living with gout

  • Current role of pharmacists in gout management Advice and education Pharmacists reported that they provided both pharmacological, diet and lifestyle advice to people with gout

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Summary

Introduction

Gout is an increasingly prevalent form of inflammatory arthritis. Gout is an extremely painful form of inflammatory arthritis characterised by high concentrations of uric acid (UA) in the blood and formation of monosodium-urate crystals within joints resulting in acute inflammation [1]. Recent reviews of Australian data suggested that the prevalence of gout has progressively increased with one study demonstrating it was 0.2% in 1968 [6], and an updated study reporting gout prevalence as 1.5% in 2013 [7]. Urate-lowering therapies (ULTs), e.g. allopurinol, are the main pharmacological treatments against gout and are typically required life-long to maintain lowered serum UA and reduce the risk of acute attacks [12]. Consumer education at the time of gout diagnosis is recommended [12]

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