Management of gout in Aotearoa New Zealand

Dr Helen Fulcher, Goodfellow GP Advisor talks with Rheumatologist, Professor Nicola Dalbeth and Consultant Prescribing Pharmacist Leanne Te Karu talks about the management of gout in New Zealand.

Topics covered include:

  • How gout affects peoples health.
  • What are the gaps in care?
  • Do some patients prefer to take NSAIDs rather than daily allopurinol despite the risk of long term joint damage?
  • Are the models of care wrong, leading to ineffective management of gout?
  • What could we do differently in primary care to improve the management of gout?
  • Take home messages to use in your clinic to improve gout management.

   

This MedTalk was recorded in April 2018

Resources

  

Peer group discussion points

1. Approximately half of Pacific men living in New Zealand and half of Māori men have gout. It has been suggested that cultural (health) literacy is an important factor in getting patients to understand gout and to be willing to take long term urate-lowering therapy.

  • Are there any techniques or resources you use in practice to help your patients to understand gout? 
  • Do you think these techniques or resources are effective in the populations you see with gout? 

2. Allopurinol is the first-line urate-lowering therapy for people with gout.

  • Do you tend to prescribe allopurinol to those with infrequent flares? If you do not, why is this?
  • Do you prescribe allopurinol to those at the second presentation of gout? If not, how do you approach the issue of long-term management of gout?
  • What ‘protocol’ do you use for the dose escalation of allopurinol? Are there any differences amongst the peer group? What are the reasons for these differences? 
  • Have you had any negative experiences with allopurinol prescribing (e.g. precipitation of a flare, hypersensitivity reactions, other)? How has this changed your prescribing practice (if at all)?

3. Gout is an undertreated chronic condition which can lead to negative sequelae. 

  • Has anyone undertaken an audit of allopurinol prescribing or gout management in their practice? What did it show? Did you make any changes to your systems or practice based on these findings?
  • What could you do differently (if anything) in your practice to improve the long-term management of gout in your patients?

This MedTalk is supported by

Date Published: 
Sunday, April 1, 2018