[Decision-making about gout by physicians of China and influencing factors thereof].

Abstract

OBJECTIVE:

To investigate the decision-making about gout by physicians of China and influencing factors thereof.

METHODS:

A questionnaire survey, including 13 multiple choice questions, was divided into 2 stages. The first/stage questionnaire survey was conducted among 121 physicians of the departments of internal medicine and rheumatology respectively during the grand ward rounds, and the second-stage questionnaire survey was conducted among 75 physicians attending a national continuous medical education (CME) workshop of rheumatology. The data thus collected were pooled and analyzed by logistic regression models.

RESULTS:

62 effective questionnaires were collected in the first/stage survey, and 38 effective questionnaires were collected in the second-stage survey, both with a missing rate < 10%. 78.3% of the respondents considered aspiration of the joint fluid as critical for the definitive diagnosis of gout, but only 2.4% of the respondents did so frequently. When treating acute gout in otherwise healthy patients, 69.2% of the respondents preferred oral colchicine, and while treating the patients with renal dysfunction, 41.7% of the respondents used corticosteroids or corticotrophin as the first choice. For long-term uric acid-lowering therapy, 99 of them (82.5%) described a variety of incorrect indications, 107 of them (89.2%) initiated the treatment too early (< or = 2 weeks after the remission), and 92 of them (76.7%) failed to sustain the treatment for at least 5 years. Only 17 physicians (14.2%) used prophylaxis while initiating the uric acid-lowering treatment and only 7 of them (5.8%) selected a prophylaxis time of 7 approximately 12 months. Multiple logistic regression analysis showed that only CMD on gout was associated with correct diagnosis strategy (OR 7.1, 95% CI 2.1 approximately 23.7).

CONCLUSION:

The management of gout by the physicians in China is often not consistent with that generally accepted internationally. High quality CME may improve the decision-making ability of physicians.

• Authors: Wei-gang Fang, Xue-jun Zeng, Meng-tao Li, Lan X Chen, H Ralph Schumacher Jr, Feng-chun Zhang
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 86 Issue 27 Pg. 1901-5 (Jul 18 2006) ISSN: 0376-2491 [Print] China
• PMID: 17064528 (Publication Type: English Abstract, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Gout Suppressants

Topics

• Decision Making
• Education, Medical, Continuing
• Gout (drug therapy)
• Gout Suppressants (therapeutic use)
• Humans
• Physicians (psychology)
• Practice Patterns, Physicians' (statistics & numerical data)
• Surveys and Questionnaires