Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Assessment of a Gout Education Session
Lonesky1, Timothy A., Brown2, L.
Gout is a growing health problem affecting 7% of men and 3% of women over 65 years of age. There is scant literature about patient understanding of gout or educational programs in management of the disease although there is abundant research about poor or mismanagement with emphasis on patient education repeatedly discussed. Also, both ACR and EULAR list efficacy of educational programs as future research agenda. This study was developed to educate our local gout population about their disease and correct various knowledge gaps with secondary goals of assessing patient characteristics, evaluating an education session with emphasis on the "match-fire" analogy adapted from Dr. Robert Wortmann's article in the Dec issue of Am J Med 1998 via a pre and post session questionairre, and evaluating any correlation between patient characteristics and gout knowledge.
ICD 9 code diagnosis of gout in Department of Rheumatology at DHMC from 20072008 were recruited to participate. 374 patients were sent an invitation, inviting them and family members to attend an evening education session at the medical center. 10 sessions were lead by a rheumatology fellow with a powerpoint presentation followed by question and answers. Patients were given a 20 true or false questionairre at the beginning and conclusion of the session.
Responders were 75% male with all of them finishing highschool and 60% attending some college. 42% had gout > 10 years. 58% had care via rheumatologist vs 42% via PCP (with 80% of these via non-physician primary). 64% felt their understanding of gout was "average." 27% knew their current uric acid level with a range of 35.4 mg/dL (all under care of rheumatologist and all answered medication questions correctly). The average pre-session correct score on the questionairre was 52% and the average post-session score was 75%. Questions with the greatest improvement in score included gouts relationship to obesity (+40%), dairy products (+59%), vitamin C (67%) along with gout being a "curable" disease with proper medical management (+53% with all patients believing this to be true by the end of the session). Participants thought the sessions were useful with a grading of 8.2 on a visual analogue scale. All participants improved their score but despite intervention, some areas continued with poor performance (<50% of participants correctly answering). These included questions about NSAID and steroid use in chronic gout treatment along with expectations of 300mg of daily allopurinol improving uric acid to < 6mg/dL.
In a highly educated population of gout patients, an intervention to improve knowledge gaps via a interactive educational session was successful however even immediately after a session, based on a true and false questionnaire, some areas of knowledge remained poor. Based on this, the visual aid "match-fire" analogy adaption, may be able to give patients a proper and easily understandable reference to the use of their medications. Future studies need to be done to see which educational interventions will improve gout management.
To cite this abstract, please use the following information:
Lonesky, Timothy A., Brown, L.; Assessment of a Gout Education Session [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1109