Owens D, Whelan B, McCarthy G
Department of Rheumatology, Mater Misericordiae Hospital, Dublin.
Ir Med J. 2008 May;101(5):147-9.
There is no information available regarding current practice and standards in management of gout in Irish general practice. This study aims to assess current practice in the context of the 2006 EULAR evidence based recommendations for diagnosis and management of gout. A 20 point questionnaire was circulated to all 170 general practitioners in the North Dublin GP Partnership assessing frequency of diagnostic and therapeutic interventions undertaken. 91% of practitioners manage gout exclusively in primary care. 89% make a diagnosis on clinical grounds and 77% routinely measure serum urate. Diagnostic joint aspiration is rarely performed (3%). 86% routinely assess and manage risk factors for gout. 66% initiate urate-lowering therapy. Only 32% routinely monitor urate levels in patients receiving urate-lowering therapy. Thus, although management of gout in primary care in Ireland is generally in line with the EULAR recommendations some aspects of care remain suboptimal.
目前尚无关于爱尔兰全科医疗中痛风管理的现行做法和标准的信息。本研究旨在根据2006年欧洲抗风湿病联盟（EULAR）关于痛风诊断和管理的循证建议，评估当前的做法。一份包含20个问题的问卷被分发给都柏林北部全科医生合作组织的所有170名全科医生，以评估所采取的诊断和治疗干预措施的频率。91%的从业者仅在初级保健中管理痛风。89%根据临床症状做出诊断，77%常规检测血清尿酸盐。很少进行诊断性关节穿刺（3%）。86%常规评估和管理痛风的危险因素。66%开始进行降尿酸治疗。在接受降尿酸治疗的患者中，只有32%常规监测尿酸水平。因此，尽管爱尔兰初级保健中痛风的管理总体上符合EULAR的建议，但某些护理方面仍不理想。
