The current state of care in gout: Addressing the need for better understanding of an ancient disease.
OBJECTIVE
To enable clinicians to initiate appropriate steps for long-term management of gout, including controlling acute exacerbations and pain and sustaining target serum uric acid (SUA) levels to control hyperuricemia as the underlying metabolic disorder.


METHODS
Incorporation of pertinent rheumatology and primary care literature seeking a comprehensive overview about the disease state of gout and its symptoms, comorbidities, and impact on quality of life, with a key focus on the role of serum uric acid, evidence-based approaches to long-term management of gout, and the importance of a functioning clinician-patient relationship.


CONCLUSIONS
Gout is increasingly recognized as a prevalent chronic disease state requiring appropriate long-term management while controlling for risk factors and comorbid conditions. Effective treatment options can help gout patients achieve therapeutic SUA targets to control gout flares and prevent potentially destructive disease manifestations. Patient education is an important element in achieving treatment goals and ensuring adherence.


CONCLUSIONS
Effective treatment plans for any gout patient must be guided by a long-term approach that focuses on sustained control of hyperuricemia, while providing continuous control of chronic disease. Patient education can be a key element in this process.
Duke University School of Nursing, Durham, North Carolina, USA.
Michael E
ME
Zychowicz
Richard S
RS
Pope
Elke
E
Graser
D000208:Acute Disease; D000368:Aged; D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D015210:Arthritis, Gouty; D001172:Arthritis, Rheumatoid; D002908:Chronic Disease; D003078:Colchicine / Q000627:therapeutic use; D015897:Comorbidity; D018450:Disease Progression; D000069465:Febuxostat; D006073:Gout / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D013844:Thiazoles / Q000627:therapeutic use; D014527:Uric Acid / Q000097:blood* / Q000378:metabolism; D014528:Uricosuric Agents / Q000627:therapeutic use; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D013844:Thiazoles; D014528:Uricosuric Agents; D000069465:Febuxostat; D014527:Uric Acid; D000493:Allopurinol; D014969:Xanthine Oxidase; D003078:Colchicine