Meyers Primary Care Institute, Worcester, MA, USA.
BMC Musculoskelet Disord. 2012 Sep 21;13:180. doi: 10.1186/1471-2474-13-180.
For patients to effectively manage gout, they need to be aware of the impact of diet, alcohol use, and medications on their condition. We sought to examine patients' knowledge and beliefs concerning gout and its treatment in order to identify barriers to optimal patient self-management.
We identified patients (≥18 years of age) cared for in the setting of a multispecialty group practice with documentation of at least one health care encounter associated with a gout diagnosis during the period 2008-2009 (n = 1346). Patients were sent a questionnaire assessing knowledge with regard to gout, beliefs about prescription medications used to treat gout, and trust in the physician. Administrative electronic health records were used to identify prescription drug use and health care utilization.
Two hundred and forty patients returned surveys out of the 500 contacted for participation. Most were male (80%), white (94%), and aged 65 and older (66%). Only 14 (6%) patients were treated by a rheumatologist. Only a minority of patients were aware of common foods known to trigger gout (e.g., seafood [23%], beef [22%], pork [7%], and beer [43%]). Of those receiving a urate-lowering medication, only 12% were aware of the short-term risks of worsening gout with initiation. These deficits were more common in those with active as compared to inactive gout.
Knowledge deficits about dietary triggers and chronic medications were common, but worse in those with active gout. More attention is needed on patient education on gout and self-management training.
为了让患者有效控制痛风，他们需要了解饮食、饮酒和药物对病情的影响。我们旨在研究患者对痛风及其治疗的认知和信念，以确定影响患者自我管理的障碍。
我们确定了 2008-2009 年间在一家多专科医疗集团实践中接受治疗且病历中至少有一次痛风诊断相关就诊记录的患者（≥18 岁，n=1346）。向这些患者发送了一份调查问卷，以评估他们对痛风的知识、对用于治疗痛风的处方药物的看法以及对医生的信任程度。使用行政电子健康记录来识别处方药物的使用情况和医疗保健的利用情况。
在联系的 500 名患者中，有 240 名患者返回了调查问卷。他们大多数是男性（80%）、白人（94%）且年龄在 65 岁及以上（66%）。仅有 14 名（6%）患者由风湿病医生治疗。只有少数患者知道常见的可引发痛风的食物（例如海鲜[23%]、牛肉[22%]、猪肉[7%]和啤酒[43%]）。在接受降尿酸药物治疗的患者中，只有 12%的患者了解药物起始治疗时痛风恶化的短期风险。这些不足在活动性痛风患者中更为常见。
对饮食诱因和慢性药物的知识不足很常见，但在活动性痛风患者中更为严重。需要更加关注痛风患者的健康教育和自我管理培训。
