title: A survey of the assessment and management of gout in general practitioners and medical officers within the Illawarra Network, Australia.
abstract: OBJECTIVE
  To review the assessment and management of gout by general practitioners (GPs) and medical officers (MOs) within the Illawarra Network, Australia.
  
  
  METHODS
  A survey was sent to GPs and MOs within the Illawarra Network.
  
  
  RESULTS
  Of 110 GPs, 45 responded. Of 129 MOs, 42 responded. The overall response was 32.6%. On analysis, 65.1% felt their knowledge of gout to be adequate and 61.6% thought they had been educated well. In acute assessment, 59.1% of GPs responded that the diagnosis of gout best be confirmed with a joint aspiration and 36.4% clinical suspicion. Differing, 85.7% of MOs chose a joint aspiration. In acute management, if colchicine were used, 59.1% of GPs would give 1 mg followed by 0.5 mg an hour later, then 0.5 mg twice daily, compared to 9.5% of MOs, while 20.5% of GPs would use 1 mg twice daily. Chronic management was answered poorly. After an acute attack, urate lowering therapy (ULT) would be started 14 days after by 47.7% of GPs, compared to 69.0% of MOs. GPs were more likely to start ULT within 7 days (52.3% vs. 31.0%). With dosing of ULT, 45.3% would treat to target, while 46.5% would dose to the creatinine clearance. Prophylactic therapy with ULT would be started by 81.8%, although only 17.4% would continue it for 3-6 months.
  
  
  CONCLUSIONS
  There is poor adherence to recommended practice for dosing of colchicine in acute gout. Also in the management of chronic gout, in particular, the timing of starting ULT and the use of prophylaxis when initiating ULT.
authors.affiliation: Rheumatology Department, Wollongong Hospital, Wollongong, New South Wales, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Terrill
authors.affiliation: Rheumatology Department, Wollongong Hospital, Wollongong, New South Wales, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Riordan
mesh_terms: D001291:Attitude of Health Personnel; D015415:Biomarkers / Q000097:blood; D003078:Colchicine / Q000008:administration & dosage; D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D058005:General Practitioners / Q000523:psychology / Q000592:standards / Q000639:trends*; D006073:Gout / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage*; D019983:Guideline Adherence / Q000639:trends; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D020445:Hospitalists / Q000523:psychology / Q000592:standards / Q000639:trends*; D006801:Humans; D009517:New South Wales; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D014528:Uricosuric Agents / Q000008:administration & dosage
chemical_list: D015415:Biomarkers; D006074:Gout Suppressants; D014528:Uricosuric Agents; D014527:Uric Acid; D003404:Creatinine; D003078:Colchicine
keywords: clinical aspects < metabolic and crystal arthropathies; education < metabolic and crystal arthropathies; metabolic and crystal arthropathies