Do you need a gout nurse?

[Keith Taylor]

9 out of 10 gout patients get better when they have someone to help them understand gout treatment.
Without that help, it’s about 3 in 10.

I’m working on a report that explains the second fact. The first fact comes from a report I first saw 2 years ago. Somebody on Twitter just reminded me. Here’s the full excerpt:

Abstract

Introduction Many doctors believe that patients with gout are unwilling to receive urate-lowering therapy (ULT) and blame them for poor
adherence to management.

Objective To test the effectiveness of a complex intervention for gout that incorporates key elements of current guidelines, including
full patient information, delivered in an optimal setting (specialist hospital clinic).

Method Observational study of patients reporting ongoing attacks of gout recruited from primary care lists. 106 participants (94
men, 12 women; mean age 61 years) were enrolled in the study. Patients received a predominantly nurse-delivered intervention
that included education, individualised lifestyle advice and appropriate ULT. The predefined goal was to achieve serum uric
acid (SUA) levels ?360 ?mol/l after 1 year in at least 70% of participants.

Results Of the 106 participants at baseline, 16% had tophi; mean (SD) baseline SUA was 456 (98) ?mol/l. All participants agreed to
joint aspiration to confirm gout and all wished to receive ULT. At 12 months, 92% of the 106 participants had achieved the
therapeutic target (SUA?360 ?mol); 85% had SUA <300 ?mol/l. Allopurinol was the most commonly used ULT, requiring a median
dose of 400 mg daily to achieve the target. Improvements in Short Form-36 were observed (significant for pain) after 1 year.

Conclusion A predominantly nurse-led intervention including education, lifestyle advice and ULT can successfully achieve the recommended
treatment target in more than 9 out of 10 patients. Full explanation and discussion about the nature of gout and its treatment
options and individualisation of management probably account for this success.

I’m not a nurse. I’ve no medical qualifications, but I do understand gout. I know how you can work with your doctor to end your gout misery. Let me help you be one of the success stories.

If you need help controlling gout, all you have to do is ask.

[Author]

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