Stuart R A, Gow P J, Bellamy N, Campbell J, Grigor R
Middlemore Hospital, Auckland.
N Z Med J. 1991 Mar 27;104(908):115-7.
to assess the prescribing habits in late 1988 of rheumatologists (NZR) and a random sample of general practitioners (NZGP) managing gout and hyperuricaemia.
self administered questionnaires containing two demographic questions and 24 items probing the selection and prescription of antirheumatic drugs in patients with acute gout, chronic tophaceous gout and asymptomatic hyperuricaemia were sent to every rheumatologist and a 10% random sample of general practitioners in active practice.
replies were received from 26 of 27 (96%) rheumatologists and 163 of 207 (79%) of general practitioners Rheumatologists were more likely to use indomethacin as the preferred drug for acute gout, and colchicine either alone or as adjunctive therapy for prophylaxis in chronic gout to prevent acute attacks occurring following the introduction of urate lowering agents, although nonsteroidal antiinflammatory drugs (NSAIDs) were more commonly used for this purpose by both groups. Prior to prescribing urate lowering therapy general practitioners were more likely to attempt control of alcohol intake, and rheumatologists more likely to avoid concomitant low dose salicylates. Allopurinol was the preferred hypouricaemic drug, with rheumatologists more likely to prescribe an initial dose of 100 mg daily, and gradually increase the dose according to the serum urate (SeUa). Although a minority of respondents prescribed allopurinol for asymptomatic hyperuricaemia, general practitioners were more likely to do so at a lower level of serum urate.
there was a high level of adherence to what is considered optimal contemporary practice, with a number of differences in prescribing habits probably reflecting differences in case selection between patients attending rheumatologists and general practitioners. The data indicates a continuing need for education programmes for both specialists and general practitioners.
评估1988年末风湿病专科医生（NZR）以及管理痛风和高尿酸血症的全科医生随机样本（NZGP）的处方习惯。
向每位风湿病专科医生以及在职全科医生的10%随机样本发送了自我管理问卷，问卷包含两个人口统计学问题以及24项关于急性痛风、慢性痛风石性痛风和无症状高尿酸血症患者抗风湿药物选择和处方的问题。
27位风湿病专科医生中有26位（96%）回复，207位全科医生中有163位（79%）回复。风湿病专科医生更倾向于使用吲哚美辛作为急性痛风的首选药物，秋水仙碱单独使用或作为慢性痛风预防的辅助治疗以防止在引入降尿酸药物后发生急性发作，尽管两组都更常用非甾体抗炎药（NSAIDs）来达到此目的。在开降尿酸治疗处方之前，全科医生更倾向于尝试控制酒精摄入量，而风湿病专科医生更倾向于避免同时使用低剂量水杨酸盐。别嘌醇是首选的降尿酸药物，风湿病专科医生更倾向于开出每日100毫克的初始剂量，并根据血清尿酸（SeUa）逐渐增加剂量。尽管少数受访者为无症状高尿酸血症开了别嘌醇，但全科医生更倾向于在血清尿酸水平较低时这样做。
对于当代最佳实践的遵循程度较高，处方习惯上的一些差异可能反映了看风湿病专科医生和全科医生的患者在病例选择上的差异。数据表明，持续需要为专科医生和全科医生开展教育项目。
