Background/Purpose: We reviewed previous treatment approaches for gout in patients referred to a university rheumatology practice for gout management. All patients met the 2015 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) gout classification criteria. We observed a paucity of concomitant prophylactic treatments that included non-steroidal anti-inflammatories (NSAID’s) and colchicine. We also observed that treat to target of serum uric acid levels was lacking. This prompted a survey of primary care physicians and medical residents to evaluate the educational gaps that might be a focus of further medical education.

Methods: A standard questionnaire was developed using input from senior rheumatologists. A core set of principles for the treatment and prevention of gouty arthritis based on the ACR/EULAR recommendations was utilized. All primary care physicians and medical residents from an academic university medical center were invited to participate in an anonymous electronic survey. Participants were requested to avoid researching or reading about management of gouty arthritis prior to survey completion. The survey was sent from the office of the Internal Medicine program director to help in improving response rates.

Results: One hundred and one out of two hundred and eight invitees, (or 48.6 percent,) completed the survey. Ninety-two percent of respondents were resident physicians and 8 percent of respondents were primary care attending physicians. Seventy-two percent of respondents felt comfortable or very comfortable in managing gout. Twenty-six percent indicated that they were very uncomfortable in gout management. Two percent of respondents indicated they would refer to a specialist for all gout management. When asked to identify a treatment target of serum uric acid only 30 percent were able to do so correctly. Fifty-six percent of respondents reported using colchicine in under one-half of the cases. Thirty-four percent of the respondents had never prescribed concomitant colchicine.

Conclusion: In our academic setting there was a lack of knowledge of the 2015 ACR/EULAR gout classification criteria and the 2012 ACR approach to management. For the most part this was in resident physicians. Too few attending physicians answered the questionnaire to be able to make any conclusions regarding their understanding of treatment for gout. Our data suggests a divergence of current clinic practices in gout treatment by residents from the recommended management guidelines. We suggest that this indicates better dissemination of knowledge to physicians in training is needed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-survey-of-knowledge-of-optimal-gout-management-in-an-academic-primary-care-setting/