Gout Arthritis

Arthritis New Zealand advocates for:

  1. All District Health Board (DHBs) to implement measures relating to gout arthritis.
  2. Gout arthritis training for primary care practitioners and across all DHBs.
  3. Ensuring that people who have had two or more gout arthritis attacks in a year are prescribed preventative medication.
  4. Reductions in numbers of people presenting to the Accident and Emergency Departments of hospitals with gout arthritis related problems.
  5. More consumer education in high risk areas. Arthritis New Zealand has developed a Continuing Professional Development (CPD) endorsed educational resource for health practitioners on gout arthritis.

Background

New Zealand has the highest per capita prevalence of gout arthritis in the world and gout arthritis is now the second most common form of arthritis in New Zealand. Māori and Pacific people have a greater genetic predisposition to develop gout arthritis than other ethnicities.  

Gout arthritis is caused by a build-up of uric acid in your blood, which forms sharp crystals in the joints. Gout is an easily managed form of arthritis – effective medications are already funded by the Government. Research evidence shows most gout arthritis is genetic in origin, although diet and other lifestyle factors can precipitate or exacerbate attacks in people with gout arthritis. 

Gout arthritis is underdiagnosed and undertreated. In primary care there is currently a lack of effective/inadequate management of gout arthritis:

  • Māori and Pacific peoples have higher rates of gout arthritis than other ethnicities. Māori and Pacific men are affected at a younger age than other groups.
  • The most at-risk populations (Māori and Pacific men) have the lowest rates of use of medicines that work to prevent gout attacks.
  • Gout contributes to unemployment and time off work.

Most gout arthritis can be managed in primary care with effective medication that lowers the amount of uric acid in the body.  For example, allopurinol is an effective preventative treatment that works for most people and is already subsidised by PHARMAC. Gout arthritis is a life-long condition therefore treatment must be long term, like the treatment of high blood pressure or diabetes. The aim of treatment is to have people with gout reduce their uric acid level to the 0.36mmol/L uric acid target to prevent further gout attacks.

Impact of Gout Arthritis

Gout is more than an intensely painful condition that can lead to joint damage and prevents people from working and participating in their communities. People with gout are also more likely than those without gout to die at a younger age due to cardiovascular and renal complications. Research has shown that those with hyperuricaemia (too much uric acid in their blood) and chronic kidney disease, that are taking urate lowering medicine, have significantly reduced risk of cardiovascular events and renal failure, compared to those not taking the medication. Another study found that patients with gout and diabetes who were taking urate-lowering medicine had significantly lower risk of heart attacked or stroke.

In New Zealand, 40% of people with gout have diabetes and/or cardiovascular disease. Despite this, many patients consider gout to be a condition that merely requires analgesics (pain killers) to control and are not aware of the potential long-term consequences. Raising community awareness about gout is an important role for health professionals in primary care.

One of the challenges of prevention is supporting people to maintain their treatment, even when they are asymptomatic. While diet and lifestyle changes such as maintaining a healthy weight are helpful in reducing risks associated with gout (as with diabetes and cardiovascular disease), urate-lowering medication is usually required to prevent future episodes.

Benefits of treating gout arthritis:

  • Prevention of gout arthritis attacks reduces the impact on health system spending in both primary and secondary care due to less frequent GP visits and reduced hospital admissions.
  • Social and economic benefits due to higher social and work participation.
  • Fewer people receiving a benefit through the benefits system.

Our commitment

Arthritis New Zealand is committed to addressing the health inequity in the management and treatment of gout arthritis for Māori and Pacific people. We have developed tailored education and support services in regions where funding has been provided, however many areas continue to have unmet need. Gout arthritis advice and information can also be accessed through our national 0800 663 463 phone line, Facebook and our website. Your Arthritis

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For further information go to the following link:
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The NZ Geographic Photographer of the Year exhibition features a finalist, Nathan Secker, whose photo depicts his aunt who suffers from gout...

"Ida Ward has lived in this house since she was married, more than 70 years ago. Now 96, Ward suffers from gout in her hands, which she covers with gloves. Nathan Secker, her nephew, felt compelled to document her and her home on a recent visit. “I didn’t ask her to move or pose for the photograph. This was Ida’s world.”

View this photo and the other finalists here: www.nzgeo.com/photography/photographer-of-the-year-2020-finalists/
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Arthritis Educator Cathie shares some tips about food that may help, food that probably isn't helping.

It's very important to know that there is no one solution for all people with arthritis - each person has got to find what works for them.
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This is an important consultation for treatments for JIA. Arthritis NZ will make a submission.

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How to implement dietary change for #osteoarthritis? Listen to this week’s episode with Rosie Venman on how to lose weight and keep it off, dietary strategies and much more! https://www.jointaction.info/podcast/episode/8b100ea7/implementing-dietary-change @NthSydHealth @KollingInst @ArthritisNZ @SydMSK

What is the difference between early #osteoarthritis and established #osteoarthritis. Check out my interview with Prof Stefan Lohmander from this week’s @jointactionorg #podcast https://www.jointaction.info/podcast/episode/8e78cf38/what-is-early-osteoarthritis @ArthritisAust @OARSInews

Arthritis New Zealand now invites applications from people or organisations involved in arthritis-related research for grants from the following funds for the period 1 July 2020 to 30 June 2021.

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Research Results out: Evaluation of Gout Stop and Owning My Gout Management Programmes
Report by Synergia for Arthritis New Zealand and its partners PHARMAC and the Health Quality and Safety Commission. Download here: https://www.arthritis.org.nz/

Stilettos, sex and sleep- although not in that order 😉- lovely conversation 🎙️with @normanswan about high heeled shoes and pain exacerbation in hip #osteoarthritis @RadioNational https://www.abc.net.au/radionational/programs/healthreport/template/12401966

Volunteer with an organisation that has core values that resonate with your own, and gain valuable work experience at the same time.
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Valerie Milne is a Researcher and has been key in advising us on the development of our peer support programme for the newly diagnosed.

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Peg and Jacob are board members and both have inflammatory arthritis. Read about why they chose to be involved in the organisation and what volunteering means to them…
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