Gout is a complex condition to treat for various reasons, Dr. Keenan said. Patients often have multiple comorbidities like diabetes or hypertension. Interaction between patients and their doctors may be poor, erecting a barrier to better self-management or treatment compliance. He suggested tagging gout treatment targets like uric acid levels to other scores for comorbidities to track overall patient progress.
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Explore This IssueFebruary 2015
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Rheumatologists should set more aggressive targets for their gout patients.
Rheumatologists and other physicians treating gout patients must change their perceptions of the disease and its management, Dr. Keenan said. “That’s the first step to making changes to the guidelines. People perceive gout as a condition requiring treatment only during flares.” Instead, providers must view gout as a condition to be managed and flares to be prevented with urate-lowering therapy, diet and other lifestyle factors.
“What about the negative attitudes of our peers and colleagues? If nobody else is following the guidelines, why should you?” he said. Gout management guidelines need to be updated and improved, and recommendations should be coordinated with new electronic management record (EMR) systems to better track patients’ progress in their overall health.
Rheumatologists should do better at condensing their message on gout diagnosis and care to a few short, simple tenets that will resonate better with colleagues in other specialties and patients, Dr. Keenan said. Changes in perceptions will lead to higher expectations and better lives for gout patients, he added.
Susan Bernstein is a freelance medical journalist based in Atlanta.