The following is a summary of “Improving Gout Care in a Canadian Academic Medical Center Through a Multidisciplinary Nurse-Led Protocol,” published in the December 2024 issue of Rheumatology by Audet et al.
Researchers conducted a retrospective study to evaluate a clinical audit and a nurse-led gout care protocol with a treat-to-target (T2T) strategy.
They audited charts of adults with gout and urate-lowering therapy (ULT) indication at a hospital. A nurse-led algorithm with allopurinol titration every 4 weeks targeted serum uric acid (SUA) control. In the postprotocol phase, adults with gout were retrospectively recruited via a billing agency until December 2020. The primary outcome was SUA target achievement at 6 months.
The results showed that 31% of 50 patients in the audit reached the SUA target at 6 months, with 16% lost to follow-up. A postprotocol cohort of 74 patients was recruited, with 43 in the protocol group and 31 in usual care. The most common ULT indication was ≥ 2 gout attacks per year (n = 52, 70%). In the protocol group, 65% (n = 28) reached the SUA target at 6 months, compared to 19% (n = 6) in the usual care group (P < 0.001). The main reason for nonachievement in the usual care group was insufficient medication titration. Around 5% were lost to follow-up, all from the usual care group.
Investigators found that a multidisciplinary, nurse-led protocol with a T2T strategy significantly improved gout care after a clinical audit. The protocol could be replicated in other regions of Canada.
Source: jrheum.org/content/early/2024/12/07/jrheum.2024-0707
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