Compliance of Primary Care Providers With Gout Treatment Recommendations—Lessons to Learn: Results of a Nationwide Survey

Social Listening in Gout: Impact of Proactive vs. Reactive Management on Self-Reported Emotional States

INTRODUCTION

This study aimed to characterize patient-reported outcomes from social media conversations in the gout community. The impact of management strategy differences on the community's emotional states was explored.

METHODS

We analyzed two social media sources using a variety of natural language processing techniques. We isolated conversations with a high probability of discussing disease management (score > 0.99). These conversations were stratified by management type: proactive or reactive. The polarity (positivity/negativity) of language and emotions conveyed in statements shared by community members was assessed by management type.

RESULTS

Among the statements related to management, reactive management (e.g., urgent care) was mentioned in 0.5% of statements, and proactive management (e.g., primary care) was mentioned in 0.6% of statements. Reactive management statements had a significantly larger proportion of negative words (59%) than did proactive management statements (44%); "fear" occurred more frequently with reactive statements, whereas "trust" predominated in proactive statements. Allopurinol was the most common medication in proactive management statements, whereas reactive management had significantly higher counts of prednisone/steroid mentions.

CONCLUSIONS

A unique aspect of examining gout-related social media conversations is the ability to better understand the intersection of clinical management and emotional impacts in the gout community. The effect of social media statements was significantly stratified by management type for gout community members, where proactive management statements were characterized by more positive language than reactive management statements. These results suggest that proactive disease management may result in more positive mental and emotional experiences in patients with gout.

Medical Students' Perspective and Knowledge of Asymptomatic Hyperuricemia and Gout Management: A Cross-Sectional Study

The prevalence and incidence of gout doubled from 1990 to 2017. Therefore, we can expect that a number of doctors have come across a patient with gout in their daily practice. Hence, we wanted to investigate how familiar our medical students, as future medical professionals, are with gout. This cross-sectional survey included Medical Studies students from the two largest universities in Croatia: the University of Split School of Medicine, and the University of Zagreb School of Medicine, and included a total of 221 fifth or sixth year medical students. Most students gave correct answers to questions about treatment approach and non-pharmacological interventions in asymptomatic hyperuricemia (>80%). Less than 3% of all students agreed they knew enough about care for patients with asymptomatic hyperuricemia, whereas almost 15% thought they were well familiar with care for gout patients. Less than 8% of students considered their school education adequate on both topics, and less than 2% were aware of the existence of EULAR guidelines. Physicians lacking in the latest knowledge on the pathophysiology of gout, the influence of lifestyle, and genetic factors limits their ability to properly manage gout. With increasing prevalence, gout should be more represented in medical students’ education.

Diagnosis and management of gout by clinicians in Nepal: a web-based survey

Patients with gout in Nepal are usually attended by medical graduates, family medicine, internists, and orthopedic surgeons. The study aimed to evaluate knowledge, attitude, and practice (KAP) of point-of-care clinicians of Nepal regarding diagnosis and management of gout and assess the quality of treatment provided to the patients. A web-based descriptive, cross-sectional study was conducted among doctors managing gout patients. The questionnaire comprises 38 multiple choice questions; 9 questions for demographic data, 8, 11, and 10 questions each for knowledge, attitude, and practice, respectively. A pilot study was conducted to observe comprehensibility of the questionnaire before subjecting it to the participants. Ethical approval was obtained from review committee of National Center for Rheumatic diseases, Nepal. Simple descriptive statistics was used to describe the correct responses. Among 1200 clinicians invited, 32% (380) participated in the survey. Maximum respondents were of age group 25-45 years (82%) with majority being internists (43%). Although only 32% understood that the disease is not curable, knowledge regarding disease was acceptable in majority (60-90%). Around 83% denied attending any gout-related seminars and 34% denied being updated with the recent guidelines. The majority of postgraduates (72%) managed the cases themselves. Although there was acceptable practice accuracy on use of therapy for acute attacks (75%), target urate levels (57%), and use of urate-lowering agents (92%), they lacked in adequate screening of co-morbidities and initiation of long-term treatment. The point-of-care clinicians have adequate knowledge to diagnose and treat acute events. However, there is poor reflection in practice and frequent update of treatment guidelines is warranted.