{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:17:31Z","timestamp":1760645851110},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T00:00:00Z","timestamp":1311811200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aim:\u2002<\/jats:bold> To determine whether implementation of a protocol to manage in\u2010hospital acute gout has improved the care of patients by non\u2010rheumatologists.<\/jats:p><jats:p><jats:bold>Method:\u2002<\/jats:bold> Two systematic case\u2010file reviews were performed to determine the management of acute gout in all episodes occurring in hospitalized patients before (April 2005\u2013December 2006) and after (November 2008\u2013September 2009) introduction of a protocol for acute gout management in a tertiary referral hospital. The protocol targeted non\u2010rheumatologists with primary intentions to continue baseline anti\u2010gout medications on admission, prevent inappropriate prescriptions of colchicine, non\u2010steroidal anti\u2010inflammatory drugs (NSAIDs) and allopurinol in the hospital, encourage invitations for assistance by rheumatology, and promote combination therapy in cases of severe gout.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> Excluding patients under the primary care of a rheumatologist, 118 cases of acute gout occurring during hospitalization were reviewed before and 89 cases after introduction of the gout protocol. Post\u2010protocol, there was a significant increase in continuation of baseline allopurinol (<jats:italic>P<\/jats:italic>\u2003=\u20030.01), significantly less inappropriate prescriptions of colchicine (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001) and allopurinol (<jats:italic>P<\/jats:italic>\u2003=\u20030.02), and a fall in the occurrence of overall adverse events (<jats:italic>P<\/jats:italic>\u2003=\u20030.01). After protocol introduction, when monotherapy was prescribed, NSAID usage declined and prednisone usage increased (<jats:italic>P<\/jats:italic>\u2003=\u20030.04), but there was no significant shift toward combination therapy use. Delays from symptom recognition to treatment were significantly reduced (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001), and rheumatology involvement significantly increased from 33.9% pre\u2010protocol to 51.7% post\u2010protocol.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> Following introduction of a hospital\u2010wide protocol for acute gout management, there have been significant improvements in the management of acute gout by non\u2010rheumatologist clinicians.<\/jats:p>","DOI":"10.1111\/j.1756-185x.2011.01642.x","type":"journal-article","created":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T09:53:42Z","timestamp":1311846822000},"page":"512-520","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Improved management of acute gout during hospitalization following introduction of a protocol"],"prefix":"10.1111","volume":"15","author":[{"given":"Narainraj","family":"KAMALARAJ","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonali R.","family":"GNANENTHIRAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theepan","family":"KATHIRGAMANATHAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geraldine M.","family":"HASSETT","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn A.","family":"GIBSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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