LAUSR

Background The prevalence and incidence of gout has risen over the past few decades and the socioeconomic costs of gout have been increasing accordingly, but it is unclear whether proper medical care is provided for patients with gout. Objectives This study aims to investigate the actual status and adequacy of diagnosis and management of gout patients. Methods The patients with gout who visited between November 2017 and February 2018 were consecutively enrolled. Data were collected using a pre-designed questionnaire and reviews of medical records. The collected data included diagnosis and management of gout before starting a steady treatment in our clinic, and disease status at first visit to our clinic. Results In total, 172 gout patients were enrolled. The average age of the patients was 55 (interquartile range (IQR): 45-66) years, and 94.2% were men. The average disease duration was 8 (IQR: 4-13) years. The average age of first gout symptoms was 45 (IQR: 36-53) years. The first symptom started in the feet for 93.4% of patients. The patients in which the first symptom region was around large joints were 35.1%, and 17.3% of patients developed first gout symptoms around multiple joints. Several patients (64%) visited the hospital directly after their first acute gout attack. The first physicians to examine gout patients were orthopedic surgeons (38.2%), emergency doctors (23.6%), and rheumatologist (16%). Upon initial medical examination, 67% of patients were clinically diagnosed or suspected with gout. Monosodium urate crystals in synovial fluid or tophi were confirmed in 10.5%. Furthermore, 31% of patients had a history of pharmacology urate lowering therapy (ULT) after acute gout attack, and 84.4% were indicated for pharmacologic ULT upon first visit to our clinic. Additionally, 47.6% of patients showed symptoms of chronic kidney disease, past urolithiasis, or tophi, and 52.4% suffered from ≥ 2 gout attacks/year. However, only 11.3% of patients were receiving continuous ULT before visiting our clinic. Conclusion Most patients were clinically diagnosed without appropriate tests for gout diagnosis, such as joint aspiration, and only a very small number of patients were receiving adequate pharmacologic ULT. The management of gout seems to be inadequate in many respects. References [1] Roddy E, Choi HK: Epidemiology of gout. Rheumatic diseases clinics of North America2014, 40(2):155-175. [2] Singh JA, Hodges JS, Toscano JP, Asch SM: Quality of care for gout in the US needs improvement. Arthritis and rheumatism2007, 57(5):822-829. [3] Young-Il S, Kyeong Min S, Young Ok J, In Je K, Kyung Lee K, Young Deok B, Hyun Ah K: Survey of Current Trends for Diagnosis and Treatment in Korean Gout Patients. J Rheum Dis2011, 18(3):187-192. [4] Doherty M, Bardin T, Pascual E: International survey on the diagnosis and management of gout. Annals of the rheumatic diseases2007, 66(12):1685-1686. Disclosure of Interests Mi Ryoung Seo Grant/research support from: I received KRW 15 million (approximately 1,300 USD) in research funding for this study from CHODANG Pharm., Ji Na Yeo: None declared, Hee Jung Ryu: None declared, Hyo-Jin Choi: None declared, Han Joo Baek: None declared