Gout Arthritis

Arthritis New Zealand advocates for: 1. All 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 2 or more gout arthritis attacks in a year are prescribed preventative medication 4. Reductions in numbers of people presenting to A&E with gout arthritis related problems 5. More consumer education in high risk areas Arthritis New Zealand has developed a 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 higher genetic predisposition to develop gout arthritis and there is a proven association between gout arthritis, diabetes and cardiovascular disease. 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. Research evidence shows 80% of gout arthritis is genetic in origin, although diet and other lifestyle factors can precipitate or exacerbate attacks in people with gout arthritis.  Māori and Pacific people have a strong genetic link with gout arthritis  Māori and Pacific men are affected at a younger age than other groups  Gout arthritis is more prevalent in men  Underdiagnosed and undertreated  In primary care there is currently a lack of effective/inadequate management of gout arthritis  Contributes to unemployment  The most at risk populations (Māori and Pacific men) have the lowest rates of Allopurinol use Impact of Gout Arthritis Gout arthritis can affect a person’s ability to contribute to family and society. If it is left untreated, over time, gout arthritis can lead to joint and kidney damage. Gout arthritis also is associated with other risk factors such as high blood pressure and diabetes, and can increase the risk of heart disease, stroke and kidney failure. Most gout arthritis can be managed in primary care with effective medication already subsidised by PHARMAC. Allopurinol is an effective preventative treatment that works for most people. Gout arthritis is a life-long condition therefore treatment must be long term, similar to the treatment of hypertension 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. One of the challenges of prevention is supporting people to maintain their treatment, even when they are asymptomatic. While diet and lifestyle changes such maintaining a healthy weight are advised – as with diabetes and CVD – this only contributes around 20% to the management of gout arthritis, but can help reduce the risk of developing gout arthritis. Benefits of treating gout arthritis:  Prevention of further gout arthritis attacks can reduce the impact on health system spending in both primary and secondary care  Reduction in health cost both in 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  Reduced hospital admissions  Fewer people receiving a benefit through the benefit 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. Arthritis New Zealand self-funded a gout arthritis awareness campaign in 2015, which focused on increasing awareness of gout arthritis and how people can reduce their risk of developing gout arthritis. This campaign also focused on increasing awareness about causative factors, which aimed to destigmatise gout and increase numbers of people being assessed and treated for gout arthritis. A Gout Patient Pathway? ANZ Gout Education and Support

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