{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T17:58:20Z","timestamp":1761155900705},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,4,1]],"date-time":"2015-04-01T00:00:00Z","timestamp":1427846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"National Health and Medical Research Council of Australia","award":["1054146"],"award-info":[{"award-number":["1054146"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>An emphasis on renal function in deciding maintenance doses of allopurinol to prevent allopurinol hypersensitivity has resulted in ineffective prevention of attacks of gout. New therapeutic guidelines for gout have shifted the focus back to titrating maintenance doses to reach a serum uric acid (<jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content>) concentration target of \u22640.36\u2009mmol\/L.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To examine trends in the prescribing of allopurinol in a teaching hospital and their concordance with the new guidelines for gout management, and to explore prescribers' approaches and attitudes to the use of allopurinol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An audit was conducted of all inpatients prescribed allopurinol at a teaching hospital between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 2008 and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2012. Allopurinol dose, <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content>, serum creatinine concentrations and estimated glomerular filtration rates were extracted from the hospital databases. Doctors from medical units who regularly prescribed allopurinol were interviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The allopurinol dose prescribed in gout patients most commonly was a continuation of the pre\u2010admission dosage. Dosage change during admission was rarely observed. Dosages reflected a consideration of renal function. <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> concentrations were measured in only 21% (<jats:italic>n<\/jats:italic> = 269) of gout patients. Prescriber interviews (<jats:italic>n<\/jats:italic> = 12) reflected adequate knowledge regarding allopurinol use, but most maintained that the primary care setting was more suitable for the management of dose titration in gout.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> concentrations were not routinely measured in the majority of admitted gout patients taking allopurinol. Without <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> measurements and allopurinol dose titration, patients with <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> &gt; 0.36\u2009mmol\/L are at increased risk for acute attacks of gout in hospital.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12701","type":"journal-article","created":{"date-parts":[[2015,2,3]],"date-time":"2015-02-03T03:32:55Z","timestamp":1422934375000},"page":"383-390","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Understanding and improving the use of allopurinol in a teaching hospital"],"prefix":"10.1111","volume":"45","author":[{"given":"R. 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