Nurse-led care improves outcomes for people with gout

What have we achieved?

由与关节炎资助的研究表明,由护士主导的beplay体育怎么下载一揽子护理可以改善治疗gout, compared to standard care. The new approach resulted in 95% of people reaching the recommended levels of urate in their blood, and patients reporting fewer painful and disabling gout attacks, leading to improved quality of life.

“I got my life back within a year” said Malcolm Coy, who received the treatment. “People don’t need to suffer that level of pain.”

What is gout?

Gout这是英国最常见的炎症性关节炎类型,是由在关节内和关节周围形成的晶体引起的痛苦疾病。痛风会影响其身体生产过多的废物产品的人,或者肾脏无法摆脱足够的尿酸盐的人。这些晶体可以在关节的衬里上摩擦,从而导致肿胀和炎症。

What problem where we trying to solve?

With the right treatment, gout is one of the few forms of arthritis which can be very effectively controlled, allowing people with this condition to live free from pain and disability. Urate-lowering therapies (ULTs), such asallopurinol, have great potential to reduce painful symptoms and improve the quality of life for people with gout. However, only about half of people with gout take ULTs, and those who do take them do not always understand the right way to take them.

In addition,misconceptions about goutand lack of education mean that people may not be getting the best care.

At Versus Arthritis, we want to make sure that people living with the pain of gout receive the best treatment possible, so we funded a study to assess whether delivering care through specially trained nurses could help people with gout.

What research did we fund, and what did it reveal?

We funded a study, led by Professor Michael Doherty at the University of Nottingham, which trained nurses to deliver individualised care to people with gout. These nurses then delivered tailored education packages in the clinic and involved patients closely in making decisions about their treatment.

两年之后,护士让的条款care resulted in:

  • 9 out of 10 people having fewer gout attacks
  • Self-reported improvements in quality of life
  • 96% of patients taking ULTs (compared to 50% receiving standard care)
  • 95% of patients having recommended urate levels (compared to 30% receiving standard care).

Nurse-led care was also shown to save the NHS money over the longer term, by keeping people’s gout under control.

How did this study change the way health professionals treat gout?

Since Professor Doherty and his team shared these findings, the National Institute for Health and Care Excellence, or NICE, has created guidelines on how to treat gout which recommend that everyone with gout is offered ULTs to help prevent attacks.

Malcolm’s story

马尔科姆(Malcolm)是由护士领导的痛风照料改变生活的人,他参加了我们资助的研究。马尔科姆对痛苦并不陌生。马尔科姆(Malcolm)在海军陆战队(Malcolm)服役后,已经忍受着“……被枪杀,刺伤和炸毁,与痛风相比,这一切都没有。”当马尔科姆发生痛风攻击时,“……它完全接管了;我无法发挥作用,无法移动,什么也没有缓解。”

Despite the fact that his gout attacks were becoming more frequent, Malcolm’s GP did not adjust the dose of allopurinol that Malcolm took.

By the time Malcolm had been living with increasing pain, anxiety and depression for four years, he said, he was in a ‘dark place’ and had considered suicide.

But when Malcolm enrolled in the study and began working with his nurse, Wendy, “I got my life back within a year”, he said. His allopurinol dose increased, his urate levels dropped, and his pain subsided. Today, Malcolm describes himself as gout-free. “I’m passionate about getting the message out there that gout is easily treatable,” said Malcolm.

Malcolm's story

What’s next?

这项研究强调,如果遵守最佳实践指南,包括监测痛风患者和个性化的护理,那么治疗对痛风非常有效。beplay体育怎么下载与关节炎一直与领先的医疗保健教育提供者合作Red Whale to deliver webinars,包括解决痛风在初级保健中的治疗并鼓励最佳实践的会议。

Professor Michael Doherty said:“We’re now looking to use our best practice model in GP practices to show that it is feasible and cost effective. We want to train practice nurses and even look at linking gout checks with yearly cardiovascular assessments. This approach would help us to check urate levels regularly and treat the condition as soon as signs of gout start to appear, which would help lots of people.”

We are also currently funding a research project to help design afull-scale clinical trial looking at whether omega-3 fatty acids, which are found in fish oils, can be used alongside ULTs to prevent gout attacks. The results could reduce gout attacks and overcome the unwanted side effects that some people experience when starting on ULTs.