Öztürk Mehmet Akif, Mercan Rıdvan, Gök Kevser, Onat Ahmet Mesut, Kısacık Bünyamin, Kimyon Gezmiş, Balkarlı Ayşe, Kaya Arif, Çobankara Veli, Balcı Mehmet Ali, Pamuk ÖmerNuri, Yıldırım Çetin Gözde, Sayarlıoğlu Mehmet, Şenel Soner, Tezcan Mehmet Engin, Küçük Adem, Üreten Kemal, Şahin Şafak, Tufan Abdurrahman
Department of Rheumatology, Faculty of Medicine Gazi University, Ankara, Turkey.
Department of Rheumatology, Faculty of Medicine Erciyes University, Kayseri, Turkey.
Clin Rheumatol. 2016 Dec;35(12):3019-3024. doi: 10.1007/s10067-016-3423-6. Epub 2016 Oct 8.
Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 ± 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications. Forty patients were referred to another center without any treatment (12.8 %), and referral rate is most common among the primary care physicians (28.8 %). Colchicine was more commonly used for attack prophylaxis than allopurinol. Ninety-two patients had never been treated with allopurinol (28.8 %). Allopurinol prescription was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. Recommendation of diet and life style modifications was less common among the primary care physicians and orthopedists, and highest among the rheumatologists. The rates of life style modification recommendation and long-term allopurinol prescription were 83.7 and 77.6 %, respectively, among the rheumatologists. Both acute and chronic management of gout is suboptimal in Turkey especially among the primary care physicians and orthopedists. Moreover, chronic treatment is even suboptimal among rheumatologists.
尽管痛风有可能治愈，但这种疾病的管理往往不尽人意。在本研究中，我们调查了土耳其痛风的治疗情况，并比较了不同临床专科对痛风的管理方法。这项多中心研究纳入了319例连续患者（平均年龄58.60±12.8岁；女性44例，男性275例）。生成了一份标准化表格，以收集有关患者首次就医、首次诊断痛风的医生专业、痛风的治疗选择（包括发作管理、患者转诊、慢性治疗，如药物治疗和生活方式改变）的数据。40例患者未经任何治疗就被转诊至另一中心（12.8%），转诊率在初级保健医生中最为常见（28.8%）。与别嘌醇相比，秋水仙碱更常用于发作预防。92例患者从未接受过别嘌醇治疗（28.8%）。别嘌醇处方在初级保健医生和骨科医生中较少见，在风湿病学家中最高。饮食和生活方式改变的建议在初级保健医生和骨科医生中较少见，在风湿病学家中最高。在风湿病学家中，生活方式改变建议率和长期别嘌醇处方率分别为83.7%和77.6%。在土耳其，痛风的急性和慢性管理都不尽人意，尤其是在初级保健医生和骨科医生中。此外，在风湿病学家中，慢性治疗也不尽人意。
