Majority of Gout Patients Don’t Understand Treatment Goals

A study of 612 gout patients shows that few patients know their serum urate goals, which researchers say could hinder their chances of reaching remission.

Led by Ted R. Mikuls, M.D., of the University of Nebraska Medical Center, researchers aimed to assess how well patients with gout understand their condition — specifically, do they understand how to achieve and maintain a recommended serum urate goal with treatment?

Of 62 percent of patients who answered the questionnaire, only 14 percent knew a target serum urate goal of < 6.0 mg/dL and nearly 80 percent expressed a general lack of knowledge about their treatment goals. Patients who received medication prescribed by a rheumatologist, as opposed to a general practitioner, had greater odds of knowing recommended serum urate levels (OR 3.0; 95% CI 1.4 to 6.2).

“There is a knowledge deficit regarding serum urate treatment goals among gout patients receiving urate lowering therapy — despite generally high levels of other gout-specific knowledge,” the authors wrote. “Serum urate goal information may be an important and underutilized concept among providers treating gout patients.”

Writing in the Jan. 19 issue of Arthritis Care and Research, researchers stated that patients should be actively engaged in decision-making regarding their treatment.

Other studies have shown that goal setting works. Patient with diabetes and hypertension have shown more improvement when they work collaboratively with their doctor to come up with a workable treatment plan and goals. But the new study in Arthritis Care and Research, which was a cross-sectional study based on a questionnaire, shows that collaborative goal-setting with patients isn’t common practice in gout care. In fact, up to 60 percent of patients do not receive a serum urate measurement within the first two years after receiving treatment. 

“Patient knowledge of disease and treatment is an important part of a complex array of psychosocial factors that have been shown to impact health outcomes. While data supporting the need for specific knowledge is limited, goal setting and goal pursuit are hypothesized to be integral aspects of persuading and motivating patients to adopt positive health behaviors,” researchers wrote.

In 2015, the American College of Rheumatology and the European League Against Rheumatism issued classification criteria for gout. Click on the above image to view a slideshow that summarizes the scoring system in an easy to use format for physicians and patients.