SAN ANTONIO – Effective gout management is critical to improving overall patient care coordination, according to research presented at the AANP 2016 National Conference.
Michael Zychowicz, DNP, ANP, ONP, FAAN, FAANP, Associate Professor and Director of the MSN program at Duke University School of Nursing, and colleagues, conducted a survey of 88 NPs and PAs to identify knowledge gaps and barriers surrounding the diagnosis, treatment, and management of gout; 25 NPs and PAs participated in an in-depth, qualitative telephone interview. The researchers also conducted qualitative telephone interviews with 12 gout patients to identify barriers related to symptom recognition, diagnosis, treatment, and follow-up care.
Among all NPs and PAs surveyed, diagnostic and treatment confidence was around 50%; researchers identified misconceptions surrounding the underlying nature of gout and found that clinician use of the full range of diagnostic tools was limited. Issues were also identified surrounding the prescribing of allopurinol and a limited use of febuxostat as a urate-lowering therapy (ULT) in eligible patients. Additionally, clinicians were unsure of appropriate monitoring and care coordination strategies and did not optimally utilize prophylactic therapy.
“Opportunities exist to educate clinicians on effective gout management and improve overall patient care coordination, specifically in regards to the monitoring of serum uric acid (SUA) levels, appropriate allopurinol dose adjustments, simultaneous initiation of prophylaxis and ULT, and selection of ULT in the presence of renal disease,” concluded Dr Zychowicz.
- Zychowicz M, Howson A, Kim D, et al. Improving gout management in primary care: findings from a mixed methods study. Poster presented at: AANP 2016 National Conference. June 21-26, 2016; San Antonio, TX.