Gout resource repository

Linda Bryant discusses gout, a chronic long-term condition that is often associated with other diseases, and with drug-related morbidity and mortality. As such, it needs to be addressed holistically as part of the psychosocial medical model.

Read the full article here.

The jury is in – usual gout care isn’t working well, especially for Māori and Pacific peoples, who are disproportionately affected by this common disorder.

What potential tools are readily available to reduce gout harm? Specific clinician actions!

Read the bulletin here.

EPiC Gout allows you to view your gout prescribing data, as well as your practice and national data. This dashboard can help you identify gout patients who could benefit from strategies designed to improve the uptake of ULT, prophylaxis against flares and treat-to-target ULT optimisation. To access EPiC gout you just need a He Ako Hiringa account.

Click here to explore EPiC Gout.

Episode three of Legendary Conversations focuses on how to better communicate with people with gout, to improve health outcomes. Professor Nicola Dalbeth, Carla White and Meihana Douglas discuss attitudes towards gout, and explain the ABC Health Literacy framework.

Listen to the episode here.

For all episodes of our Legendary Conversations podcast, click here.

Episode four of Legendary Conversations demonstrates use of the three-step ABC Health Literacy model, through an acted discussion between a prescriber and a patient. The purpose of this podcast is to show how the ABC model can be incorporated into discussions about the long-term management of gout, to help improve outcomes. Throughout this episode you'll hear learning moments that highlight different steps of the model, as well as other important lessons to note. Please note that this is the podcast version of the video Let's talk gout.

Listen to the episode here.

For all episodes of our Legendary Conversations podcast, click here.

In our recorded webinar, Professor Lisa Stamp explores the management of gout as a long-term condition and challenges old beliefs. Dr Noni Richards introduces the EPiC Gout dashboard and outlines how it can be used to highlight and address inequities.

Click here to view the recording.

ARTICLE: Beyond medicines for gout

• A set of CLASS reflection and peer group guides has been prepared specifically for pharmacists for the Beyond medicines for gout article and is available for download here.
• A 12-question assessment is available to all healthcare professionals to test your learning from the Beyond medicines for gout article. There is no pre-determined pass mark and you can do the assessment more than once.

EPiC dashboard: EPiC Reflect Gout

• This activity helps you to delve into your data in the EPiC Gout dashboard, contemplate your prescribing, reflect on your current practice, and set goals and actions. Available as an editable PDF document, EPiC Reflect helps you to incorporate your learning into your everyday practice. You can find the EPiC Reflect tab on the right hand side of EPiC Gout. You need a He Ako Hiringa account to access EPiC Gout.
• Click here to find this reflection activity in EPiC Gout.
• Click here to view the EPiC Reflect Gout PDF.

PODCASTS and VIDEO: Legendary Conversations and Let's talk gout

• Use the learning from the podcast series to complete a guided independent reflection activity on gout (download the PDF to complete it).

Our Let's talk gout video demonstrates use of the three-step ABC Health Literacy model, through an acted discussion between a prescriber and a patient. The purpose of the video is to show how the ABC model can be incorporated into discussions about the long-term management of gout, to help improve outcomes. Throughout the video you'll see learning moments pop up, highlighting different steps of the model, as well as other important lessons to note. Please note that this is the video version of the podcast Episode Four: Let's talk gout (part 2).

Watch the video here.

The Gout Guide builds on findings from several gout projects including the Whanganui GOUT STOP programme and ProCare Gout Collaborative. It provides practical tools and insights for a fresh take on gout treatment.

The guide was developed following a project funded by Te Whatu Ora, Long-Term Conditions Directorate, finishing in June 2023. Ongoing support is provided by Health Literacy NZ and Health Navigator Charitable Trust.

Click here to view the Gout Guide.

Published: April 2020.

Gout is the most common inflammatory arthritis in New Zealand, but medicines are available to manage and prevent it. This article presents the treatment options available and discusses how COVID-19 might affect prescribing decisions. Written by Leanne Te Karu and Linda Bryant.

Key points:

• There is debate and a lack of clear evidence around the use of prednisone (immunosuppression) and NSAIDs (impact on renal and cardiovascular disease) during this COVID-19 pandemic.
• When introducing urate-lowering therapy, always begin with a “start low, go slow” approach and give gout flare prophylaxis/cover.
• Follow up with patients and continue to reinforce messages at every interaction – check for understanding.
• Treat cardiovascular risk in patients with gout.

Click here to view a PDF of this article.

Published: 2 August 2021 | Updated: 11 August 2021

Talking about gout: time to re-think

Gout is a treatable form of arthritis that is associated with poor health and reduced life expectancy. Too often, gout management is focused on controlling the patient's symptoms while their risk of irreversible joint damage and negative health outcomes continues to grow. Māori and Pacific peoples are disproportionately affected by gout and often receive sub-optimal care; it is time for a re-think to address this disparity.

Click here to read the full article.

Published: 2 August 2021

Controlling gout with tong-term urate-lowering treatment

Urate-lowering medicines should be considered and discussed with patients with gout from the first presentation. Doses of urate-lowering medicines need to be titrated to effect so that patients consistently have serum urate levels that are below target. Three urate-lowering medicines are available in New Zealand and patients who are unable to achieve treatment targets with allopurinol alone should be offered an alternative regimen.

Click here to read the full article.

Published: 4 May 2018

Summary
This audit enables identification of patients with gout who are taking allopurinol, and determines if they have been treated to target.

• Allopurinol doses should be titrated to achieve a target serum urate < 0.36 mmol/L
• Serum urate levels should be tested at least annually, once the serum urate target has been reached, as part of routine patient monitoring

Click here to complete the clinical audit.

Atlas of Healthcare Variation

This Atlas domain presents information on gout by district health board (DHB) including prevalence by ethnicity and treatment. It identifies areas of wide variation between different parts of the country and opportunities for quality improvement. View the gout domain of the Atlas.

Measures Library

The measures library is a repository of information about measures of the health care system. This includes technical documents, information related to quality improvement, case documents and data visualisations. View the Measures Library and search for "gout".

This article published in the International Journal for Equity in Health explores the inequities experienced by Pacific peoples with gout and outlines a novel innovative intervention strategy to improve the uptake of urate-lowering therapy in this population.

Click here to read the article.

These online courses provide professional development for clinical and non-clinical staff who work with people who have arthritis. There are two gout arthritis courses available, one is a general overview most suitable to support workers, kaiāwhina, health navigators, and people supporting people with arthritis. The ‘Update’ course is of most use to clinicians such as nurses, doctors, pharmacists, specialists and other healthcare providers.

Click here to see the courses.

This report from Pharmac explores the prescribing and dispensing of medicines for gout, with a focus on the impact on Māori.

Click here to read the report.

This report from Pharmac explores the data around Pacific peoples with gout. This report was developed to support people in the decisions they make to improve the management of gout, and enhance the well-being of Pacific peoples.

Click here to read the report.

Recorded: April 2018.

Dr Helen Fulcher, Goodfellow GP Advisor, talks with Rheumatologist Professor Nicola Dalbeth and Consultant Prescribing Pharmacist Leanne Te Karu about the management of gout in New Zealand.

Topics covered include:

• How gout affects people's health.
• What are the gaps in care?
• Do some patients prefer to take NSAIDs rather than daily allopurinol despite the risk of long term joint damage?
• Are the models of care wrong, leading to ineffective management of gout?
• What could we do differently in primary care to improve the management of gout?
• Take home messages to use in your clinic to improve gout management.

Click here to view the full MedTalk.

Reviewed: 2016

Healthtalk spoke to a range of people about what they wanted from their healthcare professionals when managing their gout.

There is a series of short videos to watch, which are interspersed with a list of things healthcare professionals can do that can make a positive difference for people living with gout.

Click here to see the resources.

Updated: 4 April 2019

This page includes recorded presentations from a Pharmac Rheumatology Update seminar held on 23 November 2018.

Videos include:

1. Rheumatoid arthritis - Prof. Andrew Harrison
2. Psoriatic arthropathy - Dr Will Taylor (parts 1, 2)
3. Gout - Dr Guy Taylor (parts 1, 2)
4. Osteoporosis - Prof. Ian Reid (parts 1, 2)
5. Telemedicine in rheumatology care for rural practice - Frances Kasmi

Click here to watch the recordings.

Recorded: 1 July 2020

View the Health Quality & Safety Commission's webinar about new equitable approaches to gout management in Aotearoa New Zealand.

Two primary care models of gout management are presented, along with the findings of a major new report describing the key components for establishing and maintaining gout management programmes in primary care.

Speakers are Sandy Bhawan, Prof. Nicola Dalbeth, Dr Aniva Lawrence, Diana Phone and Susan Reid. This webinar is for anyone working in pharmacy, planning and funding, or primary care including Māori and iwi health providers, general practice and primary health organisations.

Click here to find the recorded webinar.

Recorded: May 2018

This webinar was presented by Dave Cox, Primary Care Liaison Co-ordinator for Arthritis New Zealand.

The webinar covers:

• An overview of gout in New Zealand
• Diagnostic criteria
• Treatment of acute attacks
• Treatment to prevent further gout attacks
• New British Society for Rheumatology (BSR) guidelines
• Arthritis New Zealand and available supports.

The webinar can be watched on YouTube here.

These webinars from Health Literacy NZ are specifically designed for health coaches working as part of the Integrated Primary Mental Health and Addictions Implementation Services – also known as Access and Choice.

Understanding Gout : Part 1 on Vimeo Dr Nicola Dalbeth
Understanding Gout: Part 2 on Vimeo How to talk about gout by Carla White & Susan Reid

Updated: 18 August 2021

This section of the HQSC website is organised to support providers wanting to start quality improvement projects of their own in primary care. The intention is that providers who want to start quality improvement in one of these areas can look at past examples from Whakakotahi and gain some tips and tools to support them in their work.

Information on Gout projects can be found here.

Published: March 2016

The GoutHappyFeet webpage hosts several PDF documents for you and your patients.

Initiating allopurinol with prophylactic medicine can be managed by blister packaging for the first three months of therapy. This proves helpful for managing acute treatment, titration of allopurinol, and short-term use of prophylactic medicine.

For starter pack regimens, see the orange box titled For Health Professionals, and open the PDFs called "Treating and preventing gout in 7 minutes".

Click here to go to the webpage.

Updated: 18 October 2021

A new consumer poster is available in English and te reo Māori to help patients, caregivers, families and whānau talk about medication with their health care providers.

Good communication between patients and health professionals helps to reduce the risk of medication-related harm. Patients are at particularly high risk of fragmented care, adverse drug events and medication errors during ‘transitions of care’, where a patient moves between one care setting and another.

Click here to find the English and te reo Māori versions of this poster.

Updated: 15 September 2021

The Healthify website provides patient information on allopurinol including a dosing titration plan, precautions, side effects, interactions and answers to commonly asked questions about taking allopurinol.

Click here to view and download the information.

Published: November 2018

The My Medicines website provides an easy-to-view, printable guide to allopurinol for patients and clinicians.

Click here to view in English.

Click here to view in te reo Māori.

Reviewed: June/July 2021

The healthinfo.org.nz gout section is split into four different areas:

• Overview of gout
• Self-care for gout
• Eating & lifestyle advice for gout
• Medications for gout

Explore the full gout section here (click on G, then gout).

The HealthInfo gout management plan can be viewed and downloaded here.

Updated: 19 October 2020

The Ministry of Health NZ website has gout information for patients on treatment, prevention and living with gout.

Two PDF's are available to download and talk through with your patients and their whānau.

• Are you at risk of gout?
• To STOP GOUT you need to bring your uric acid levels down.

The full MoH webpage can be found here.

Accessed: 18 October 2021

The Arthritis New Zealand website has loads of information to support your patients and their whānau with gout arthritis.

The gout arthritis page explains what gout is, who gets it, the warning signs, and how to manage the condition. There are also videos and printable leaflets. Direct your patients here.

The Arthritis Assist page outlines the services on offer, including:

• Free telephone and email help and advice from an arthritis educator
• Facebook page
• Peer support service
• Online and community support groups

Accessed: 18 October 2021

The Healthify website provides several resources for your patients, and includes the following sections:

• Gout (an overview)
• Gout medications
• Gout apps
• Gout videos
• Self management

Click here to access these resources.

Accessed: 18 October 2021

Arthritis Assist is a free support and advice service available to people who want to talk about their gout (or other forms of arthritis).

The Arthritis NZ educators are health professionals who are available by phone or email, Monday to Friday, to answer questions from patients about their arthritis. The educators are trained to give advice on all forms of arthritis, treatments, pain management, exercise, nutrition and how to live well with arthritis.

Patients can call Arthritis New Zealand educators on 0800 663 463 or fill out an online form to request a call back.

Click here for more information.

In this video series, Dr Vanisi Prescott explains what gout is, how to manage it, and tackles some misconceptions about the condition.

1. What is gout?
2. Gout is not your fault
3. Deciding to take Allopurinol for gout
4. Starting on Allopurinol for gout
5. Gout and young Māori and Pacific men
6. Gout attacks
7. Gout medicines – what you need to know
8. Taking gout medicines