Pitfalls in management of acute gouty attack, a qualitative research conducted in Makah Region – Saudi Arabia

  • Mustafa H
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OBJECTIVE<br />To probe doctors’ attitudes and reveal wrong perception in the management of acute gouty attacks. <br /><br />DESIGN<br />A descriptive study using a designed questionnaire that was completed through face to face interviews in hospitals, health units and polyclinics in the Makah Region. <br /><br />METHOD<br />This is a qualitative study of treatment by 99 doctors conducted in the second half of 2012. The sample included orthopedists, rheumatologists, general practitioners and family physicians. <br /><br />RESULTS<br />72 (72.7%) doctors started treatment of acute attacks with mono-therapy. 58 doctors (58.6%) started with NSAIDs. Indomethacin was the most frequent prescribed NSAIDs. 18 doctors (18.2%) prescribed Allopurinol as the first drug of choice. 42 doctors (43.8%) started Allopurinol “2 weeks after acute attack”. 31 doctors (32.3%) mentioned that they used 100 mg daily dose. 41 doctors (42.7%) mentioned that the starting dose depends on the patient’s condition. Allopurinol was prescribed once daily by 37 doctors (38.9%). 53 doctors (55.8%) used Allopurinol as prophylaxis. The most frequent test requested was a 24-h urine test for uric acid. In case patients were already on Allopurinol and presented with an acute attack of gout; 33 doctors (34.7%) tended to “increase the dose”. The most important factor in adjusting the Allopurinol dose is Serum Uric Acid Level. 37 doctors (39.4%) mentioned that they ask for Serum Uric Acid Level every 3–4 weeks. <br /><br />CONCLUSION<br />There were common pitfalls that need a training program to increase awareness of doctors with general guidelines and recommendations. The most critical pitfalls include prescribing Allopurinol in acute gouty attacks and ignoring the Renal Function Test.




Mustafa, H. (2015). Pitfalls in management of acute gouty attack, a qualitative research conducted in Makah Region – Saudi Arabia. Alexandria Journal of Medicine, 51(2), 121–125. https://doi.org/10.1016/j.ajme.2014.04.004

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