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沙特阿拉伯初级保健医生对痛风治疗建议的认知与实践:一项横跨五个不同地区的横断面研究。

Knowledge and practice of gout treatment recommendations by primary health care physicians in Saudi Arabia: A cross-sectional study across five different regions.

作者信息

Alharbi Samar, Alharthi Nada, Almuteri Dhai, Jan Raghad, Alsaedi Saba, Alwakeel Abdulaziz, Alhumaidi Nidaa

机构信息

Department of Medicine, College of Medicine, Taibah University, Medina, Saudi Arabia.

King Salman Medical City, Medina, Saudi Arabia.

出版信息

Medicine (Baltimore). 2025 Jul 4;104(27):e43179. doi: 10.1097/MD.0000000000043179.

DOI:10.1097/MD.0000000000043179
PMID:40629586
Abstract

Gout, the most common inflammatory arthritis in developed countries, can lead to deformities and disabilities, significantly affecting quality of life. Primary care physicians (PCPs) play a crucial role in its management and must adhere to recent guidelines. This study assessed PCPs' knowledge and adherence to gout treatment recommendations in Saudi Arabia using a questionnaire survey. A total of 367 PCPs completed the survey, with 86.4% practicing in Saudi Arabia. The respondents included general physicians (53.1%) and family physicians (49.9%), with a nearly equal gender distribution. For acute gout management, 25.34% recommended nonsteroidal anti-inflammatory drugs combined with corticosteroids. Colchicine was considered safe by 69.8% of participants. Knowledge of urate-lowering therapy was suboptimal, with only 7.9% correctly identifying the appropriate initiation timing and 43.1% recognizing the target serum uric acid (SUA) level. While 74.1% recommended modifying therapy if the SUA target was unmet, only 32% advocated for long-term urate-lowering therapy. Additionally, 18% correctly identified the proper time to measure SUA levels. Lifestyle modifications were acknowledged by 57.2%, and 55% recognized the cardiovascular risks associated with gout. Overall, PCPs demonstrated poor compliance with gout management guidelines. Strategies to improve adherence include continuing medical education, disease-management websites, and smartphone apps. Rheumatologists should serve as key resources for PCPs, providing education through consultations, formal training, and conference presentations.

摘要

痛风是发达国家最常见的炎性关节炎,可导致畸形和残疾,严重影响生活质量。初级保健医生(PCP)在痛风管理中起着关键作用,必须遵循最新指南。本研究通过问卷调查评估了沙特阿拉伯初级保健医生对痛风治疗建议的了解程度和遵循情况。共有367名初级保健医生完成了调查,其中86.4%在沙特阿拉伯执业。受访者包括全科医生(53.1%)和家庭医生(49.9%),性别分布几乎相等。对于急性痛风的管理,25.34%的医生推荐非甾体抗炎药联合皮质类固醇。69.8%的参与者认为秋水仙碱是安全的。降尿酸治疗的知识掌握情况欠佳,只有7.9%的人正确识别了合适的起始时机,43.1%的人认识到目标血清尿酸(SUA)水平。虽然74.1%的人建议在未达到SUA目标时调整治疗,但只有32%的人主张进行长期降尿酸治疗。此外,18%的人正确识别了测量SUA水平的合适时间。57.2%的人认可生活方式的改变,55%的人认识到痛风相关的心血管风险。总体而言,初级保健医生对痛风管理指南的依从性较差。提高依从性的策略包括继续医学教育、疾病管理网站和智能手机应用程序。风湿病学家应作为初级保健医生的关键资源,通过会诊、正规培训和会议演讲提供教育。

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本文引用的文献

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Knowledge and Practice of Primary Health Care Providers in the Management of Asymptomatic Hyperuricemia and Gout in the Qassim Region of Saudi Arabia.沙特阿拉伯卡西姆地区初级卫生保健提供者在无症状高尿酸血症和痛风管理方面的知识与实践
Cureus. 2022 Nov 1;14(11):e30976. doi: 10.7759/cureus.30976. eCollection 2022 Nov.
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Moving the Needle in Gout Management: The Role of Culture, Diet, Genetics, and Personalized Patient Care Practices.推动痛风管理的进展:文化、饮食、遗传和个体化患者护理实践的作用。
Nutrients. 2022 Aug 31;14(17):3590. doi: 10.3390/nu14173590.
3
Association of acidic urine pH with impaired renal function in primary gout patients: a Chinese population-based cross-sectional study.
基于中国人群的一项横断面研究:酸性尿液 pH 值与原发性痛风患者肾功能损害的相关性。
Arthritis Res Ther. 2022 Jan 25;24(1):32. doi: 10.1186/s13075-022-02725-w.
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The incidence and prevalence of cardiovascular diseases in gout: a systematic review and meta-analysis.痛风患者中心血管疾病的发病率和患病率:系统评价和荟萃分析。
Rheumatol Int. 2021 Jul;41(7):1209-1219. doi: 10.1007/s00296-021-04876-6. Epub 2021 May 13.
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The Epidemiology and Genetics of Hyperuricemia and Gout across Major Racial Groups: A Literature Review and Population Genetics Secondary Database Analysis.不同主要种族群体高尿酸血症和痛风的流行病学与遗传学:文献综述及人群遗传学二级数据库分析
J Pers Med. 2021 Mar 22;11(3):231. doi: 10.3390/jpm11030231.
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How Are We Managing Patients with Hyperuricemia and Gout: A Cross Sectional Study Assessing Knowledge and Attitudes of Primary Care Physicians?高尿酸血症和痛风患者的管理现状如何:一项评估初级保健医生知识和态度的横断面研究?
Int J Environ Res Public Health. 2021 Jan 30;18(3):1234. doi: 10.3390/ijerph18031234.
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Prevalence and Trends in Kidney Stone Among Adults in the USA: Analyses of National Health and Nutrition Examination Survey 2007-2018 Data.美国成年人肾结石的患病率和趋势:对 2007-2018 年国家健康和营养调查数据的分析。
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Compliance of Primary Care Providers With Gout Treatment Recommendations-Lessons to Learn: Results of a Nationwide Survey.基层医疗服务提供者对痛风治疗建议的依从性——可吸取的经验教训:一项全国性调查的结果
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