title: An Observational Study of Gout Prevalence and Quality of Care in a National Australian General Practice Population.
abstract: OBJECTIVE
  The central strategy for effective gout management is longterm urate-lowering therapy to maintain the serum urate at a level below 0.36 mmol/l. We sought to determine the prevalence of gout and the quality of care in a national Australian general practice population.
  
  
  METHODS
  Data were from general practice point-of-care electronic records over a 5-year period (n = 1,479,449). Information was collected on patients with gout according to a validated definition. All patients who visited the same general practices over the study period formed the denominator group. We determined the estimated prevalence of gout, the frequency of allopurinol prescription, and serum urate testing, and the percentage of patients achieving a target serum urate level.
  
  
  RESULTS
  The crude prevalence of gout in this general practice population was 1.54% (95% CI 1.52-1.56). Prevalence in men was 2.67% and in women 0.53%. Prevalence increased with age in both men and women (4.90%, 95% CI 4.82-4.99, in men > 65 yrs). Allopurinol was prescribed to 57% of patients with gout during the 5 years of the study. Only 55% of patients with gout had their serum urate tested at any time during the 5-year study period. A target serum urate concentration of < 0.36 mmol/l at any time during the 5-year study period was documented in 22.4% of all people with gout.
  
  
  CONCLUSIONS
  Gout is managed poorly in Australian primary care, with low levels of allopurinol prescribing and serum urate testing. Collectively, these factors probably contribute to low achievement of serum urate targets.
authors.affiliation: From the Centre for Neurogenetics and Statistical Genomics, Queensland Brain Institute, University of Queensland, Brisbane, Queensland; Department of Rheumatology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Department of Medicine, Wellington School of Medicine, University of Otago, Wellington; Bone and Joint Research Group, University of Auckland, Auckland, New Zealand.P.C. Robinson, MBChB, PhD, FRACP, Centre for Neurogenetics and Statistical Genomics, Queensland Brain Institute, University of Queensland, and Department of Rheumatology, Royal Brisbane and Women's Hospital; W.J. Taylor, MBChB, PhD, FRACP, Department of Medicine, Wellington School of Medicine, University of Otago; N. Dalbeth, MBChB, MD, FRACP, Bone and Joint Research Group, University of Auckland. philip.robinson@uq.edu.au.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Robinson
authors.affiliation: From the Centre for Neurogenetics and Statistical Genomics, Queensland Brain Institute, University of Queensland, Brisbane, Queensland; Department of Rheumatology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Department of Medicine, Wellington School of Medicine, University of Otago, Wellington; Bone and Joint Research Group, University of Auckland, Auckland, New Zealand.P.C. Robinson, MBChB, PhD, FRACP, Centre for Neurogenetics and Statistical Genomics, Queensland Brain Institute, University of Queensland, and Department of Rheumatology, Royal Brisbane and Women's Hospital; W.J. Taylor, MBChB, PhD, FRACP, Department of Medicine, Wellington School of Medicine, University of Otago; N. Dalbeth, MBChB, MD, FRACP, Bone and Joint Research Group, University of Auckland.
authors.forename: William J
authors.initials: WJ
authors.lastname: Taylor
authors.affiliation: From the Centre for Neurogenetics and Statistical Genomics, Queensland Brain Institute, University of Queensland, Brisbane, Queensland; Department of Rheumatology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Department of Medicine, Wellington School of Medicine, University of Otago, Wellington; Bone and Joint Research Group, University of Auckland, Auckland, New Zealand.P.C. Robinson, MBChB, PhD, FRACP, Centre for Neurogenetics and Statistical Genomics, Queensland Brain Institute, University of Queensland, and Department of Rheumatology, Royal Brisbane and Women's Hospital; W.J. Taylor, MBChB, PhD, FRACP, Department of Medicine, Wellington School of Medicine, University of Otago; N. Dalbeth, MBChB, MD, FRACP, Bone and Joint Research Group, University of Auckland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use*; D001315:Australia; D057286:Electronic Health Records; D005260:Female; D058006:General Practice; D006073:Gout / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011787:Quality of Health Care; D012737:Sex Factors; D014527:Uric Acid / Q000097:blood; D055815:Young Adult
chemical_list: D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol
keywords: GOUT; PREVALENCE; QUALITY OF CARE; SERUM URATE