MBChB, FRACP, PhD, Professor and Rheumatologist, Department of Medicine, University of Otago, Christchurch, NZ.
MBChB, MD, FRACP, Rheumatologist, Department of Rheumatology, Immunology and Allergy, Christchurch Hospital, Christchurch, NZ.
Aust J Gen Pract. 2019 Sep;48(9):631-637. doi: 10.31128/AJGP-04-19-4909.
The aim of this project was to determine the effects of a package of care for gout in primary care.
An audit of gout management in a single rural medical practice was undertaken before (in 2012) and after (in 2015) the introduction of the package of care reflecting guidelines in gout management.
There was a statistically significant increase in the number of individuals commenced on allopurinol ≤100 mg/d and a decrease in the number commenced on allopurinol ≥200 mg/d (P <0.001). The number of times each patient had serum urate tested between 2012 and 2015 (median [range] 1 [0-3] versus 2 [0-10], respectively; P <0.001). Of those individuals who had at least one serum urate measurement, the number of individuals who were never at target urate was 43 out of 67 (64.2%) in 2012, compared with 52 out of 133 (39.1%) in 2015 (P = 0.001).
A package of care can improve adherence to gout management guidelines in primary care.
本项目旨在确定初级保健中痛风综合护理包的效果。
在引入反映痛风管理指南的综合护理包之前（2012 年）和之后（2015 年），对单一农村医疗实践中的痛风管理进行了审核。
开始使用≤100mg/d 别嘌醇的人数呈统计学显著增加，而开始使用≥200mg/d 别嘌醇的人数减少（P<0.001）。每位患者在 2012 年至 2015 年期间进行血清尿酸检测的次数（中位数[范围]：1[0-3]次与 2[0-10]次；P<0.001）。在至少进行过一次血清尿酸测量的患者中，2012 年有 67 例患者中从未达到目标尿酸水平的有 43 例（64.2%），而 2015 年有 133 例患者中从未达到目标尿酸水平的有 52 例（39.1%）（P=0.001）。
综合护理包可以提高初级保健中痛风管理指南的依从性。
