基层医疗中痛风管理的挑战：最佳实践审核结果。

The challenges of managing gout in primary care: Results of a best-practice audit.

机构信息

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.

出版信息

Aust J Gen Pract. 2019 Sep;48(9):631-637. doi: 10.31128/AJGP-04-19-4909.

DOI:10.31128/AJGP-04-19-4909

PMID:31476837

Abstract

BACKGROUND AND OBJECTIVES

The aim of this project was to determine the effects of a package of care for gout in primary care.

METHOD

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.

RESULTS

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).

DISCUSSION

A package of care can improve adherence to gout management guidelines in primary care.

摘要

背景与目的

本项目旨在确定初级保健中痛风综合护理包的效果。

方法

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。

结果

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）。