Gout management may be better under nurse-led care

Keeping people fully informed and involving them in decisions about their care can result in more  successful management of gout, says a new study funded by Versus Arthritis.

People with gout can make lifestyle changes such as losing weight if overweight, which can help bring down urate levels and has other general health benefits. But gout can effectively be “cured” with urate-lowering therapies. The dose needs to be adjusted against the blood urate level until a target low level is achieved. New crystals are prevented from forming and any crystals already present slowly dissolve.

However, only 40% of people with gout ever receive urate-lowering therapy and getting patients to stick to their medication is tricky.

The new study saw 500 people with gout being split into groups. Half were under the guidance of nurses and the other half received usual care from their GP. The research nurses delivered a holistic assessment, discussion about perceptions of the illness, full information about gout and patient involvement in decision-making.

Nurse-led care was associated with a much higher take up of urate-lowering therapy, greater adherence to treatment, better urate levels in the blood, fewer flare ups, reduced tophi (firm, white lumps below the surface of the skin caused by a mass of urate crystals), improved quality of life and was more cost effective, saving the NHS money after five years.

Stephen Simpson, Director of Research at Versus Arthritis, comments:

“Currently, constraints on GP’s time mean patients are not fully aware of the benefits that come with taking their treatments. We are optimistic that if the methods of treatment used in this study are incorporated into national guidelines for GPs we will see a much more effective long-term management of gout, an improvement in the quality of life a person has after an attack, as well reducing healthcare costs over time.”

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