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The following is a summary of “Knowledge of and Stated Adherence to the 2020 American College of Rheumatology Guideline for Gout Management: Results of a Survey of US Rheumatologists,” published in the January 2025 issue of Rheumatology by Schlesinger et al.
Researchers conducted a retrospective study to evaluate rheumatologists’ stated adherence to the 2020 American College of Rheumatology (ACR) Gout Management Guideline.
They administered a 57-item questionnaire to a sample of US rheumatologists. Stated adherence scores were calculated based on guideline recommendations followed in practice, while stated agreement scores reflected whether respondents always followed the recommendations.
The results showed that all 201 rheumatologists completed the questionnaire, with a mean stated adherence score of 11.5 (max 15) and a mean stated agreement score of 7.7 (max 14). Less experienced rheumatologists (≤ 8 yrs; n = 49) had a higher adherence score (12.3) vs more experienced rheumatologists (> 8 yrs; n = 152; 11.3; P ≤ 0.05). Rheumatologists seeing ≤ 75 patients with gout in 6 months (n = 66) had a higher adherence score (12.1) than those seeing > 75 patients (11.2; P ≤ 0.05). Approximately 78% followed the guideline for initiating urate-lowering therapy, and 89% prescribed allopurinol as first-line ULT. Adherence to dosing recommendations was lower for febuxostat (43%) and allopurinol (39%). Rheumatologists from academic settings were more likely to prescribe interleukin-1 inhibitors for gout flares.
Investigators found that the self-reported practices of US rheumatologists were generally aligned with the 2020 ACR Gout Management Guideline. However, gaps in guideline knowledge and adherence were evident, particularly regarding treatment dosing.
Source: jrheum.org/content/52/1/77