Review Finds Gout Therapy Monitoring 'Suboptimal' Among Veterans
A retrospective chart review found that rates of urate-lowering therapy monitoring among United States veterans with gout were less than optimal. The full findings are published in the Annals of Pharmacotherapy.
According to the 2012 American College of Rheumatology gout guidelines, timely monitoring is important in achieving serum urate goals. However, not many studies have evaluated the level of adherence to these recommendations. To evaluate adherence to urate-lowering therapy monitoring guidelines, Jonathan C. Hughes, PharmD, from the VA Tennessee Valley Healthcare System, Nashville, TN, and colleagues conducted a single-center, multisite, retrospective chart review of 601 U.S. veterans receiving urate-lowering therapy for gout within the VA Tennessee Valley Healthcare System from January 1, 2013 to June 30, 2015.
The primary endpoint was the percentage of patients with a serum urate level within 6 months of first xanthine oxidase inhibitor prescription. Secondary endpoints included percentage of patients with serum urate level <6mg/dL and the percentage of patients with uptitration following serum urate above goal.
Of the total veteran patients that met the study criteria, 505 were included for final analysis. The study authors found that 58% (n=295) of patients did not have a serum urate level drawn within 6 months and 32% (n=162) reached the end of the study period without a measurement of their serum urate level.
Of the 226 patients with serum urate levels above goal at initial check, 28% (n=64) had timely dose adjustment and 63% (n=143) had no adjustment. Dr. Hughes reported that within the study period, only 32% (n=161) had serum urate at goal levels.
Overall, the rates of urate-lowering therapy monitoring at a major veterans affairs medical center "were suboptimal, and improved adherence to guideline recommendations is needed," noted study authors.
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