Gout

Messages about gout for health professionals

The people we talked to had messages for health professionals including:

•    Be sympathetic, listen, and understand how painful gout can be. Talk to each patient as an equal. Make sure that practice staff know how painful attacks can be, and that urgent appointments or advice may be needed if someone has no medication at home to treat an attack.
•    Take gout seriously. Managing it well is a high priority for people even though it is not life-threatening.

•    Remember that gout can affect joints other than the big toe, and also women as well as men. 

•    Gout can affect younger people too. Consider issues related to treatment like pregnancy/breastfeeding for younger women with gout. 

•    Find out about the causes and treatment options for gout, and give people enough verbal and written information to manage their gout. 
•    Make time to talk about gout and treatment options with people rather than telling them only about what you have prescribed. 

•    Refer to a specialist if initial treatments are not working and/or people are experiencing recurring attacks. This is better than repeatedly prescribing different medications to see if they work.

•    Tell patients to come back if they continue to have attacks. 

•    Let people know that gout is not a life-threatening condition, and though it can’t be cured, it can be managed very effectively with the right treatments. 
•    Trust patients, and give them confidence that they can manage the condition themselves with appropriate support.

•    Regularly monitor uric acid levels and kidney function (e.g. every year). Ask people if they are still having attacks/symptoms to check treatment is effective and provide reassurance that there are no unwanted long-term effects.
•    Explain and give reassurance about the reasons for doing blood tests to check things like kidney function. 

•    Be aware of the impact that gout attacks may be having on the patient’s everyday life as well as on their family and friends. 

•    Once gout is diagnosed, prescribe enough medication for treating attacks so that people can keep a supply at home rather than having to get to the surgery when they are in pain.

•    Prescribe enough medication so that patients who are taking long-term tablets do not have to have repeat prescriptions too frequently.
•    It is important to think about treatments to prevent attacks and joint damage rather than only those that treat the symptoms of individual attacks. 

•    Explain the difference between treatments for attacks and long-term treatments. 
•    Make sure people are aware that attacks may still happen for up to two years after starting ongoing medication.

•    Gout is not usually self-inflicted. It is important to be aware of the myths about the causes of gout. Find out what the patient knows and believes so that you can make sure they have a good understanding. 
•    Inform patients that diet has less of an impact on triggering attacks than people may think. Reducing high purine foods and alcohol might make a difference, but this is unlikely to reduce uric acid levels enough to prevent attacks and/or long-term damage. 

•    Advise people about where they can find information about gout and diet, or refer them to a dietician if appropriate.


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Last reviewed December 2016

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