Download 822-2456-1

1. Table 1 Audit criteria based on BSR guidelines
Theme
Guideline
Criteria
Assessment of gout
All patients presenting
-Patient recorded sUA 4-6 weeks
patients
with acute gout should
after diagnosis of gout
have their serum urate
checked after 4-6 weeks
Management and
Allopurinol prescribed
-Patients having sUA levels tested
monitoring of
and titrated until
since initiation of medication
chronic gout
sUA<300micromol/l
-Patients having allopurinol dosage
reviewed based on sUA
-Patients having sUA<300micromol/l
Indications of
Allopurinol is started in
allopurinol
patients with second

>1 attack of gout in a year
attack within a year, renal

renal insufficiency
insufficiency, tophi, uric

tophi
acid stones and

uric acid stones
continuing treatment on

continuous treatment of
diuretics
-Patient with
diuretics
not on allopurinol
2.
Figure 1: Data extracted from medical record in chronological order
Patient demographics
Patient had serum
urate checked after
gout attack
Type of acute
treatment
Allopurinol
initiated
Yes



Serum urate rechecked
Dosage titration
Serum urate target
achieved
No






>1 episode of gout within a
year
presence of tophi
history of chronic kidney
disease
history of uric acid stone
use of diuretics
unchecked sUA
3. Figure 2 Pie chart of gender distribution of gout patients
Gender distribution
22%
Male
Female
78%
4. Figure 3 Pie chart of patients reviewed witihin 4-6 weeks
Patient review
Within 4-6 weeks
46%
54%
Not within 4-6
weeks
5. Figure 4 Pie chart demonstrating types of treatment for acute gout
Acute Management
NSAIDs
18%
2%
17%
Colchicine
63%
Steroids
No medications
6. Figure 5 Pie chart showing usage of allopurinol
Usage of Allopurinol
39%
Allopurinol
61%
Not on allopurinol
7. Table 2 shows findings of patients on allopurinol
Regular sUA checks
Yes
No
42 (67%)
21 (33%)
Altered dosage based on sUA
20 (31%)
43 (69%)
Achieved target sUA<300micromol/l
12 (19%)
51 (81%)
8. Table 3 shows findings of patients not on allopurinol
Yes
No
> 1 attack in a year
12 (29%)
29 (71%)
Renal insufficiency
11 (27%)
32 (78%)
Tophi
1 (2%)
40 (98%)
Diuretics
7 (17%)
34 (83%)
Checked sUA
15 (37%)
26 (63%)
Uncontrolled sUA
9 (60%)
6 (40%)