The Study
More allopurinol is needed to get gout patients < 0.36 mmol/l: a gout audit in the form of a before-after trial.
This study watched what happened to gout patients after doctors sent them letters and called them on the phone. It saw that, on average, their uric acid levels went down — but we can't be sure the letters and calls caused it, because other things might have changed too, like what they ate or how much they slept.
Analysis score
Maximum 72 for a cohort study.
Where the score came from
Many gout patients stop taking their medicine too soon, even when it works. This study tried reminding them by mail and phone to keep taking it.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 554 / 100
Quality score
Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Going from 38% to 50% means many more patients are now protected from painful gout attacks — a meaningful improvement in real life.
- 2Before reminders: 38–43% of patients had safe uric acid levels.
- 3After reminders over 10–16 months: 50% had safe levels.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Journal of primary health care
Year
2009
Authors
B. Arroll, M. Bennett, N. Dalbeth, Dilanka Hettiarachchi, C. Ben, Ginnie Shelling
Related Content
Claims (6)
When serum uric acid levels are below 0.36 mmol/L, gout is considered under control, and patients do not need to continue taking high doses of allopurinol.
In patients with gout, combining a higher dose of allopurinol with mail and phone reminders increases the percentage of patients who reach target uric acid levels from 38% to 50%.
Electronic audits using existing medical software can detect patients with gout and measure their blood uric acid levels, allowing primary care providers to compare performance and implement focused treatments.
In primary care, about 38% to 43% of gout patients have serum uric acid levels below 0.36 mmol/L, even though most are prescribed allopurinol.
Most people with gout believe they should stop taking allopurinol after a short time, and this belief is linked to persistently high uric acid levels even when doctors prescribe the drug correctly.
Non-English-speaking patients of Pacific and Māori descent experience reduced understanding of gout treatment goals and medication instructions in primary care due to language barriers.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.