Terrill Matthew, Riordan John
Rheumatology Department, Wollongong Hospital, Wollongong, New South Wales, Australia.
Int J Rheum Dis. 2018 Feb;21(2):517-522. doi: 10.1111/1756-185X.13097. Epub 2017 May 25.
To assess the beliefs and knowledge of gout management in new medical graduates.
A survey on gout management was sent to new medical graduates during their orientation week, New South Wales, Australia.
Of 15 hospital networks, 11 agreed to participate. From these, 168 graduates responded (23.7% response rate). Most (81.1%) felt that gout was a serious disease, 51.2% answered that they had been taught adequately to manage acute gout, only 37.2% for chronic gout. In an acute gout flare, 63.4% answered they would continue urate lowering therapy and 67.2% were aware of first-line pharmacological management options; 28% answered the correct dosing regimen for colchicine. Chronic management was answered poorly. Only 42.0% stated they would titrate allopurinol dosing to a target urate level; 23.5% would check the urate level monthly. More than half, 56.8%, were aware that medical prophylaxis is indicated when initiating urate lowering therapy. Of this subgroup, 46.7% (25.9% overall) knew that non-steroidal anti-inflammatory drugs and colchicine were recommended and 28.4% (15.4% overall) answered the correct timeframe of use. Close to one-third (35.0%), were aware of febuxostat, probenecid and benzbromarone as second-line urate lowering therapy.
The findings of this study suggest that new graduates' knowledge of gout management, especially chronic management, is suboptimal. Many felt their teaching on gout management inadequate; this is a potential target for intervention. Up to date university education which covers chronic management may lead to better clinical outcomes for this burdensome disease.
评估新毕业医学学生对痛风管理的认知和知识。
在澳大利亚新南威尔士州新毕业医学学生入职培训周期间，开展了一项关于痛风管理的调查。
15个医院网络中，11个同意参与。其中，168名毕业生做出回应（回应率为23.7%）。大多数人（81.1%）认为痛风是一种严重疾病，51.2%的人回答他们接受过充分的急性痛风管理培训，而慢性痛风管理培训的知晓率仅为37.2%。在急性痛风发作时，63.4%的人回答他们会继续进行降尿酸治疗，67.2%的人知晓一线药物管理方案；28%的人回答了秋水仙碱的正确给药方案。慢性管理方面回答不佳。只有42.0%的人表示他们会将别嘌醇剂量滴定至目标尿酸水平；23.5%的人会每月检查尿酸水平。超过一半（56.8%）的人知道在开始降尿酸治疗时需要进行药物预防。在这个亚组中，46.7%（总体为25.9%）知道推荐使用非甾体抗炎药和秋水仙碱，28.4%（总体为15.4%）回答了正确的使用时间范围。近三分之一（35.0%）的人知道非布司他、丙磺舒和苯溴马隆作为二线降尿酸治疗药物。
本研究结果表明，新毕业学生对痛风管理的知识，尤其是慢性管理方面，并不理想。许多人觉得他们接受的痛风管理培训不足；这是一个潜在的干预目标。涵盖慢性管理的最新大学教育可能会为这种负担沉重的疾病带来更好的临床结果。
