title: Gout treatment: survey of Brazilian rheumatology residents.
abstract: To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate <6 mg/dL for patients without tophi was reported by >75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and <50% reported maintaining urate-lowering therapy indefinitely for patients without tophi. Among residents and PR, the residency stage was the main predictor of concordance with the ACR guidelines, with PR achieving the greatest rates. Reported practices were commonly concordant with the 2012 ACR gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.
authors.affiliation: Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil. rodrigo_b_c_amorim@yahoo.com.br.
authors.forename: Rodrigo Balbino Chaves
authors.initials: RBC
authors.lastname: Amorim
authors.affiliation: Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Ana Beatriz
authors.initials: AB
authors.lastname: Vargas-Santos
authors.affiliation: Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Leticia Rocha
authors.initials: LR
authors.lastname: Pereira
authors.affiliation: Epidemiology Department, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Evandro Silva Freire
authors.initials: ESF
authors.lastname: Coutinho
authors.affiliation: Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Geraldo
authors.initials: G
authors.lastname: da Rocha Castelar-Pinheiro
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use*; D019983:Guideline Adherence; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D000072140:Rheumatologists / Q000193:education*; D012219:Rheumatology / Q000193:education*; D011795:Surveys and Questionnaires
chemical_list: D006074:Gout Suppressants
keywords: Gout; Residency; Rheumatology; Rheumatology residency; Survey