title: Nurse-led cardiovascular disease risk management intervention for patients with gout.
abstract: BACKGROUND
  Patients with gout are at high risk for cardiovascular disease (CVD), and this risk is frequently under-managed.
  
  
  OBJECTIVE
  To evaluate a nurse-led multidisciplinary approach to improve CVD risk management in patients with gout.
  
  
  METHODS
  Patients referred to rheumatology clinics for gout management received a structured nurse-led CVD risk assessment. For the patients with an initial 5 year risk >10%, interventions for CVD prevention were identified and goals developed. These patients were then reassessed approximately 6 months later to determine changes in CVD risk management and profile.
  
  
  RESULTS
  Of 210 patients with gout, 73% had either a 5-year CVD risk >10% or had known CVD. Of these higher risk patients, 84% were available for follow-up. Compared with the initial visit there were improvements at follow-up in: the prescription of aspirin, statins, nicotine replacement therapy, uptake of self-reported activity levels, mean systolic and diastolic blood pressure, with a trend towards reduced cigarette smoking.
  
  
  CONCLUSIONS
  A nurse-led intervention to assess and manage cardiovascular risk in patients with gout is effective in improving uptake of preventative interventions.
authors.affiliation: Department of Cardiology, Middlemore Hospital, Auckland, New Zealand. AZMcLachlan@middlemore.co.nz
authors.forename: Andy
authors.initials: A
authors.lastname: McLachlan
authors.forename: Andrew
authors.initials: A
authors.lastname: Kerr
authors.forename: Mildred
authors.initials: M
authors.lastname: Lee
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology / Q000451:nursing / Q000517:prevention & control*; D015331:Cohort Studies; D005260:Female; D006073:Gout / Q000150:complications* / Q000451:nursing*; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult