Information for patients diagnosed with gout
It is important for patients to understand the need for lifelong urate-lowering therapy. Patients with untreated gout are at increased risk of recurrent acute attacks and long-term damage to the joints and kidneys if urate-lowering therapy is not started. It may be an incentive for patients to know that previously hesitant patients who start urate-lowering therapy become strong advocates for early treatment after experiencing substantial improvementsFitzGerald, 2020.
Nonadherence to urate-lowering therapy also increases the risk of flare and is a common reason for treatment failure. Nonadherence to treatment is a particular problem in patients with gout because joint function is relatively normal between acute attacks early in the disease, the management regimen is complex at the start of treatment, and patients have a natural reluctance to take lifelong drug therapy. Discussing the consequences of inadequately treated gout has an important role in encouraging treatment adherence.
Advise patients not to stop or reduce the dose of urate-lowering therapy during an acute attack because sudden changes in serum uric acid concentration can prolong or worsen the attack.
Discuss with patients the benefits of maintaining a healthy lifestyle (eg maintaining ideal body weight, exercising regularly, stopping tobacco smoking); having a diet that is geared towards being in a healthy weight range, and limiting the intake of alcohol (especially beer and spirits), fructose-sweetened drinks and other foods or drinks that are known to trigger a flare in individuals. While there is strong evidence that lifestyle factors increase the risk of gout, evidence that correcting these factors improves outcomes is lacking.
Printed or online information reinforces education messages; useful patient information leaflets on ‘Gout’ and ‘Gout and diet’ are available on the Arthritis Australia website1.