Clinical Practice on Gout Management Among Filipino General Care Practitioners

Mary Flor Joy Y. Edar, Julie Li-Yu

Sep 2017 DOI 10.35460/2546-1621.2017-0052     Access   

Abstract

Title: Evidence-based practice guidelines for gout management is widely available. However, management by general care practitioners is still far from ideal.

Objectives: This study aims to determine the current trends in the management of gout among general care practitioners.

Methodology: Survey questionnaires randomly distributed to the general membership of the Philippine College of Physicians (PCP) and the Philippine Academy of Family Physicians (PAFP).

Results: A total of 390 respondents participated, the majority being females (237, 60.8%) with a mean age of 37.32 + 10.22 (20-75) years, half of them holding practice within Metro Manila. The duration of practice was divided into four categories: 72 (18.5%) had <1 year of practice, 138 (35.4%) had 1-5 years of practice, 64 (16.4%) 5-10 years, and 116 (29.7%) had >10 years of practice. Two hundred and twelve (54%) respondents did not attend gout continuing medical education (CME) activities. More than half agreed with synovial fl uid examination to confi rm gout diagnosis in patients with acute monoarthritis. During a gout fl are, 60.5% preferred colchicine while 15.8% prescribed uratelowering therapies. Colchicine dosing 3x daily was preferred in 30.3% while 17.4% advocated hourly dose until GI toxicity. Urate-lowering therapies (ULT) 1-2 weeks after the gout fl are was preferred by 43.3% while 37.4% opted to give it until serum uric acid level (SUA) normalized before discontinuation. Most respondents (60%) chose prophylactic colchicine when starting ULTs. Half of the respondents (49.7%) aimed for SUA level of 6 mg/dL. In chronic tophaceous gout, 46.9% targeted a higher value of 5 mg/dL.

Conclusion Though gout management has improved among general care practitioners, there were still observed inconsistencies and heterogeneous patterns of practice in the community.

Keywords: gout survey, adherence to gout guidelines, Filipino.

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