Research news

Nurse-led gout management improves patient-centred outcomes

Research study finds people with significantly lower rates of flare-ups and nodes in managed intervention group 

Research study finds people with significantly lower rates of flare-ups and nodes in managed intervention group


Picture: Science Photo Library

Gout is an arthritis caused by the formation of sodium urate crystals. It is associated with pain, joint damage, subcutaneous nodules, poor quality of life and increased mortality.

Urate-lowering drugs dissolve existing crystals and prevent new ones. Health promotion addresses risk factors, such as high alcohol intake. Half of those with gout receive urate lowering treatment in the UK. This randomised control trial compared nurse-led gout care to usual general practitioner (GP) care.

Research nurses were trained in management of gout, including a protocol for urate lowering medicines, and 517 patients with gout were randomly assigned to nurse (the intervention) or GP-led care (the control). 

Greater uptake

At two years follow-up, the intervention group had greater uptake and adherence to urate-lowering medicines than the control group. Significantly more intervention patients (95%) had serum urate concentrations in the normal range compared to the control group (30%). 

Intervention patients had significantly lower rates of flare-ups and nodes and higher quality of life scores than the control group. 

The cost per quality-adjusted life-year gained for the nurse-led intervention was £5,066 at two years and modelled to save costs by five years.

The authors concluded that nurse-led gout care improved patient-centred outcomes and was cost-effective compared with usual care.


Reference


Compiled by Vari Drennan, professor of healthcare and policy research at Kingston and St George’s, University of London

This article is for subscribers only

Jobs