Abstract
Background
Gout is one of the most common conditions encountered in primary care. This study aims to assess urate control among gout patients managed in primary care settings and to evaluate its associated risk factors.
Method
Retrospective cross-sectional study. All adult Chinese gout patients who had been followed up in public primary care clinics from 1 January 2021 to 31 December 2021 were included. Patient demographics, clinical and biochemical parameters were retrieved from the computer system. Student’s t-test was used for analyzing continuous variables and Chi-square test was used for categorical data. Multivariate stepwise logistic regression was used to determine the associated risk factors for poor urate control.
Results
Among the 385 gout patients included, 115 met the target serum urate level (29.9%). All patients with tophaceous gout could not achieve the target serum urate level. In multivariate studies, male gender (OR 2.587, 95% CI: 1.374–4.873), active smoker (OR 3.170, 95% CI: 1.077–9.333), Chronic kidney disease with stage 3a, 3b and 4, (OR 3.236, 3.122 and 10.250 respectively, 95% CI: 1.556–6.732, 1.113–8.758 and 1.078–97.477 respectively) were less likely to meet the target urate level while those on urate-lowering agents (OR 0.225, 95% CI: 0.0.127–0.399) were more likely to meet the target urate level.
Conclusion
Only 29.9% of gout patients were adequately treated in public primary care settings in Hong Kong. Tophaceous gouty patients are found to have difficulties in achieving target serum urate level. Gout patients who were male, active smokers, having Chronic kidney disease with stage 3a, 3b and 4 were less likely to meet the target urate level while those on urate-lowering agents were more likely to meet the target urate level.