title: Demographic and clinical profile of nursing facility residents with gout.
abstract: OBJECTIVE
  To develop a demographic and clinical profile of nursing facility residents with a diagnosis of gout.
  
  
  METHODS
  Descriptive, retrospective database analysis.
  
  
  METHODS
  U.S. nursing facilities.
  
  
  METHODS
  Nursing facility residents with a diagnosis of gout.
  
  
  METHODS
  Minimum Data Set and prescription claims records of residents served by Omnicare, Inc., with an International Classification of Diseases Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of gout, for the time period of October 1, 2009, to September 30, 2010, were linked and de-identified. Acute gouty attacks were defined by a proxy measure of a ? 14-day course of oral nonsteroidal anti-inflammatory drugs (NSAIDs), oral or injectable steroids, or oral colchicine.
  
  
  RESULTS
  In the 138,724 residents (36.8% male: 76.8% white, 11.6% black) evaluated, the incidence of gout was 1.8% (n = 2,487). Of those with gout, males and females were represented relatively equally. There were 1,420 (57.2%) residents 80 years of age or older. Two-thirds of residents with gout required at least extensive assistance with most activities of daily living. Comorbid conditions-hypertension (82.2%), diabetes mellitus (46.6%), arthritis (43.7%), and renal failure (22.4%)-were common. Pain was reported in 68.7% of residents. Allopurinol (60.2%), colchicine (18.6%), febuxostat (2.3%), probenecid (1.1%), and probenecid/colchicine (< 1%) were prescribed in treated residents. While treatment may or may not have been indicated, 375/2,152 (17.4%) received no treatment. Diuretic therapy was received by 75.8% of residents. Acute gouty attacks were noted in 38% of residents; 53%, 25.2%, and 21.8% received short-course treatment with oral or injectable steroids, oral colchicines, or oral NSAIDs, respectively.
  
  
  CONCLUSIONS
  Despite the limitations of a retrospective database analysis, this study reveals that nursing facility residents with a diagnosis of gout have significant disease burden. Clinicians should be aware of the potential impact of this disease on physical functioning, pain, and falls in this often-frail population.
authors.affiliation: Wayne State University, Detroit, MI, USA. barbara.zarowitz@omnicare.com
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Zarowitz
authors.forename: Terrence E
authors.initials: TE
authors.lastname: O'Shea
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D016208:Databases, Factual; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006073:Gout / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D006074:Gout Suppressants; D003078:Colchicine