{Reference Type}: Journal Article
{Title}: Incorporating gout guideline advice into urate reports is associated with reduced hospital admissions: results of an observational study.
{Author}: Riches PL;Downie L;Thomson C;
{Journal}: Rheumatology (Oxford)
{Volume}: 0
{Issue}: 0
{Year}: Sep 2021 16
{Factor}: 7.046
{DOI}: 10.1093/rheumatology/keab689
{Abstract}: <B>OBJECTIVE: </B>To evaluate the impact of incorporating treatment guidance into reporting of urate test results.<BR><B>METHODS: </B>Urate targets for clinically confirmed gout were added to urate results above 0.36 mmol/l requested after September 2014 within NHS Lothian. Scotland-wide data on urate-lowering therapy prescriptions and hospital admissions with gout were analysed between 2009 and 2020. Local data on urate tests were analysed between 2014 and 2015.<BR><B>RESULTS: </B>Admissions with a primary diagnosis of gout in Lothian reduced modestly following the intervention from 111/year in 2010-2014-104/year in 2015-2019, a non-significant difference (p= 0.32). In contrast there was a significant increase in admissions to remaining NHS Scotland health boards (556/year vs 606/year, p< 0.01). For a secondary diagnosis of gout the number of admissions in NHS Lothian reduced significantly (58/year vs 39/year, p< 0.01) contrasting with a significant increase in remaining Scottish health boards (220/year vs 290/year, p< 0.01). The relative rate of admissions to NHS Lothian compared with remaining Scottish boards using a 2009 baseline were significantly reduced for both primary diagnosis of gout (1.06 vs 1.25, p< 0.001) and secondary diagnoses of gout (0.64 compared with 1.4, p< 0.001) after the intervention; however, there was no difference before the intervention. A relative increase in the prescription rates of allopurinol 300 mg tablets and febuxostat 120 mg tablets may have contributed to the improved outcomes seen.<BR><B>CONCLUSIONS: </B>Incorporation of clinical guideline advice into routine reporting of urate results was associated with reduced rates of admission with gout in NHS Lothian, in comparison to other Scottish health boards.