29 Jan 2016 | Health Quality Intelligence
The latest Atlas of Healthcare Variation shows a continuing gap between populations with the largest prevalence of gout and those being prescribed the most effective drug for its treatment.
The updated gout Atlas has been released by the Health Quality & Safety Commission, building on data which was published in 2013.
In New Zealand, gout is the most common form of inflammatory arthritis affecting adults. It can cause severe joint pain, disrupt work and home life and cause difficulty playing sports and other normal activities. If left untreated, gout can damage bones and joints.
The data shows Māori and Pacific peoples are more affected by gout, with at least twice the rates of other non-Māori, non-Pacific groups. However, they are less likely than these other groups to receive effective therapies.
Professor Nicola Dalbeth, chair of the Commission’s expert advisory group on gout, says that while the most common and well-tolerated medicine for gout prevention is allopurinol, Māori and Pacific peoples receive it less frequently.
“Patients who take allopurinol regularly don’t need as many other medicines to treat gout and have lower rates of hospital admission. We don’t know how many people should be taking allopurinol but data suggests there are people for whom taking it would improve their health.
“On average, 41 percent of people with gout received allopurinol regularly. However, among those populations with the highest rates of gout that number is lower – 39 percent for Māori and 33 percent of Pacific peoples.
“This is similar to 2011 data which showed allopurinol use was inversely related to gout prevalence and Pacific peoples received the least amount of the drug.
“The data shows there is no ‘one size fits all’ approach to the management of gout – but we hope clinicians can use the information to improve outcomes for patients living with this condition.”
Gout affects about 4.7 percent of New Zealand’s adult population.
It is caused by a build-up of uric acid (also called urate) in the blood. Uric acid is a substance in your body. It is normal to have some uric acid in your body but when it is high you are more likely to get gout. Most people get rid of uric acid through their urine (mimi).
It is recommended that a person who is having more than one acute gout attack per year take regular medication to reduce the amount of uric acid in the blood to prevent further acute gout attacks.
This Atlas presents information on gout in the district health boards of New Zealand. The information includes how common gout is, whether certain groups of people are more likely to get gout, and what sorts of treatments are being used. It compares treatment for gout and shows, for example, how many people are prescribed medicine for acute gout attacks and how many people with gout receive long-term medicine to prevent acute gout attacks.
The Atlas uses maps, graphs, tables and text to show differences by geographic area about how and what health services are provided.
The Atlas is one way to start debate and raise questions about health service use among clinicians, users and providers of health services about why variation exists, and to promote improvement through this debate.
Atlas findings are intended to encourage discussion about why variation in health care exists rather than make assumptions about the cause of variation.