Roughly 30% of patients with gout did not re- ceive an anti-inflammatory medication upon discharge, and opioids were frequently overused in gout management in the emergency depart- ment (ED), according to a study published in The Annals of Pharmacotherapy. Investigators sought to identify pharmacotherapy use related to gout treatment before, during hospital visit or stay, and on discharge in patients presenting to the ED with gout flares. Secondary end points included opioid use, revisit rates, and associat- ed risk factors. They performed a retrospective cohort study at a community teaching hospital ED. All consecutive patients visiting the ED from January 2016 to July 2019 with a primary diagnosis of gout flare were included. The analy- sis included 214 patients and data were extracted from the electronic medical records. Researchers found that anti-inflammatory medication was not prescribed in 33.6% during the hospital visit and 29.6% of patients on discharge. History of opioid use (odds ratio [OR] = 3.3; 95% confi- dence interval [CI] = 1.3-8.6) and gastroesoph- ageal reflux disease (OR = 3.5; 95% CI = 1.09- 10.9) were associated with opioid prescription on discharge. ED revisits within 90 days for any gout-related or non-gout-related cause were re- corded in 16.8% of patients. “The increased costs of gout care in the United States may be a result of a lack of adherence to treatment guidelines and medication knowledge,” the study authors wrote. “Therefore, identifying causes for this trend is vi- tal to mitigate inappropriate resource use. There is an opportunity for further education of health care providers regarding gout treatment.”
