The challenges of managing gout in primary care: Results of a best-practice audit

BACKGROUND AND OBJECTIVES: The aim of this project was to determine the effects of a package of care for gout in primary care. METHOD: An audit of gout management in a single rural medical practice was undertaken before (in 2012) and after (in 2015) the introduction of the package of care reflecting guidelines in gout management. RESULTS: There was a statistically significant increase in the number of individuals commenced on allopurinol ≤100 mg/d and a decrease in the number commenced on allopurinol ≥200 mg/d (P <0.001). The number of times each patient had serum urate tested between 2012 and 2015 (median [range] 1 [0-3] versus 2 [0-10], respectively; P <0.001). Of those individuals who had at least one serum urate measurement, the number of individuals who were never at target urate was 43 out of 67 (64.2%) in 2012, compared with 52 out of 133 (39.1%) in 2015 (P = 0.001). DISCUSSION: A package of care can improve adherence to gout management guidelines in primary care.