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

  • Mustafa H
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Abstract

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.

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APA

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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