title: Management of gout in a South Auckland general practice.
abstract: BACKGROUND
  In New Zealand, the highest prevalence of gout is in Maori and Pacific people. Counties Manukau District Health Board (CMDHB) has the highest Maori and Pacific population of any New Zealand District Health Board. A CMDHB study found that a high proportion of patients with gout were also at increased risk of cardiovascular disease.
  
  
  METHODS
  The primary objective was to examine whether the control of gout had changed over time at one clinic. The secondary objective was to assess the management of cardiovascular risk factors in patients with gout at that clinic.
  
  
  RESULTS
  The mean serum uric acid level of patients with gout in the practice had risen in comparison with a similar audit carried out in March 2009. This indicates that the control of gout for patients at the practice has worsened over time. Many patients had not had an annual serum uric acid test.
  
  
  METHODS
  A repeat uric acid level was scheduled for all patients with gout in the practice, with follow-up appointments to be arranged if the result was abnormal.
  
  
  CONCLUSIONS
  Gout is often suboptimally managed. Serum uric acid levels may only be tested when a patient presents with an acute attack of gout. Consideration should be given to a minimum of annual serum uric acid levels. Appropriate management of modifiable cardiovascular risk factors in this particular cohort is important and should be a particular focus of care.
authors.affiliation: Aberdeen Royal Infirmary, Aberdeen, Scotland. esther.reaves@nhs.net.
authors.forename: Esther
authors.initials: E
authors.lastname: Reaves
authors.affiliation: General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
authors.forename: Bruce
authors.initials: B
authors.lastname: Arroll
mesh_terms: D058006:General Practice; D006073:Gout / Q000188:drug therapy / Q000208:ethnology / Q000517:prevention & control / Q000652:urine; D006801:Humans; D009520:New Zealand; D010818:Practice Patterns, Physicians'; D014527:Uric Acid / Q000652:urine
chemical_list: D014527:Uric Acid