Amy D. Nguyen, PhD

Almost one-third of residents with gout living in aged care facilities did not receive urate-lowering therapy (ULT), according to a study published in Rheumatology Advances in Practice.

For those who did receive ULT, short courses of treatment were common, but inadequate.

Amy D. Nguyen, PhD, and colleagues assessed treatment for gout based on general management guidelines for aged care facilities. To identify people with gout, gout medication use, and other chronic conditions, the study team examined EHR data linked with clinical notes and electronic medication administration information for 11,548 residents older than 65 in 68 residential aged care facilities. “… We examined the use of ULT and medications for gout flares in the gout cohort identified, with respect to resident length of stay, age, sex, and comorbidities,” the study authors wrote.

The proportion of patients receiving ULT, preventative medication and/or colchicine/NSAID use for treating gout flares, the duration of these treatment episodes, and the number of ULT and colchicine/NSAID treatment episodes (periods of continuous days of medication use) were the outcomes examined.

Hypertension Was the Most Common Comorbidity Among Residents

Among all participants in the cohort, 10% (N=1,179) had gout. Of these, 62% used an ULT, with a median of one episode of use for a short time [median, 4 days; median of use in total (ie, repeated use), 52 days]. Among residents with gout, 9% also used colchicine or an NSAID. The researchers observed that female residents were less likely to receive ULT and, if they did, it was for shorter periods of time. Hypertension was the most common comorbidity in residents with gout (71%), followed by dementia (47%) and diabetes (34%). During the study period, 49% of patients in the gout cohort died.

“Overall, management of gout in aged care residents appears to be suboptimal, largely owing to intermittent and short exposure to ULT … with female residents at greater risk for poor gout management,” the study authors noted.

Dr. Nguyen and colleagues would like to see future research investigate why gout management within residential aged care settings is not in agreement with established guidelines. Doing so will ensure that residents receive proper gout management to lessen the incapacitating painful effects of gout., according to the researchers.