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Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol

INTRODUCTION: Gout is the most common inflammatory arthritis in the Dutch general practice population and is often managed with long-term uric acid lowering treatment. The clinical relevance of this treatment in preventing gout attacks is unclear. PRIMARY RESEARCH QUESTION: What is the frequency of...

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Autores principales: van Leeuwen, Kevin D B, Bohnen, Arthur M, Jacobs, Marloes L, van Der Lei, Johan, Janssens, Hein J E M, Koffeman, Aafke R, Bindels, Patrick J E, Bierma-Zeinstra, Sita M A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254413/
https://www.ncbi.nlm.nih.gov/pubmed/30478125
http://dx.doi.org/10.1136/bmjopen-2018-024335
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author van Leeuwen, Kevin D B
Bohnen, Arthur M
Jacobs, Marloes L
van Der Lei, Johan
Janssens, Hein J E M
Koffeman, Aafke R
Bindels, Patrick J E
Bierma-Zeinstra, Sita M A
author_facet van Leeuwen, Kevin D B
Bohnen, Arthur M
Jacobs, Marloes L
van Der Lei, Johan
Janssens, Hein J E M
Koffeman, Aafke R
Bindels, Patrick J E
Bierma-Zeinstra, Sita M A
author_sort van Leeuwen, Kevin D B
collection PubMed
description INTRODUCTION: Gout is the most common inflammatory arthritis in the Dutch general practice population and is often managed with long-term uric acid lowering treatment. The clinical relevance of this treatment in preventing gout attacks is unclear. PRIMARY RESEARCH QUESTION: What is the frequency of self-reported gout attacks and what is the effect of allopurinol use in patients diagnosed with gout in general practice? METHODS AND ANALYSIS: Adult patients with a diagnostic consultation code for gout in the year 2013, 2014 or 2015 will be invited to participate in this prospective observational cohort study. Patients with a limited life expectancy will be excluded. Baseline measurements will include blood pressure, body mass index and a blood sample (estimated glomerular filtration rate, serum uric acid, cholesterol (low-density lipoprotein (LDL) and high-density lipoprotein), glucose (fasting)). At the 2-year follow-up, patients will receive questionnaires every 3 months. The questionnaires at baseline, 12 months and 24 months assess the frequency of gout attacks, the presence of tophi, comorbidity, medication use, quality of life, diet and lifestyle. The questionnaires in between only assess the frequency of gout attacks and medication use for gout. Descriptive statistics will be used to calculate the mean frequency of self-reported gout attacks during the 2-year follow-up. The propensity score for each patient being offered allopurinol is estimated and used to match patients with and without allopurinol treatment. We will compare the frequency of gout attacks in these groups using multilevel Poisson regression analyses. With this type of analysis, we can calculate the corrected estimated effect of allopurinol on gout attack frequency. ETHICS AND DISSEMINATION: The research protocol was approved by the Medical Ethical Committee of the Erasmus Medical Centre in Rotterdam. The knowledge generated by this study will be transferred to the Dutch College of General Practitioners, conferences and to (inter)national peer-reviewed journals. TRIAL REGISTRATION NUMBER: NTR6329; Pre-results.
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spelling pubmed-62544132018-12-11 Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol van Leeuwen, Kevin D B Bohnen, Arthur M Jacobs, Marloes L van Der Lei, Johan Janssens, Hein J E M Koffeman, Aafke R Bindels, Patrick J E Bierma-Zeinstra, Sita M A BMJ Open General practice / Family practice INTRODUCTION: Gout is the most common inflammatory arthritis in the Dutch general practice population and is often managed with long-term uric acid lowering treatment. The clinical relevance of this treatment in preventing gout attacks is unclear. PRIMARY RESEARCH QUESTION: What is the frequency of self-reported gout attacks and what is the effect of allopurinol use in patients diagnosed with gout in general practice? METHODS AND ANALYSIS: Adult patients with a diagnostic consultation code for gout in the year 2013, 2014 or 2015 will be invited to participate in this prospective observational cohort study. Patients with a limited life expectancy will be excluded. Baseline measurements will include blood pressure, body mass index and a blood sample (estimated glomerular filtration rate, serum uric acid, cholesterol (low-density lipoprotein (LDL) and high-density lipoprotein), glucose (fasting)). At the 2-year follow-up, patients will receive questionnaires every 3 months. The questionnaires at baseline, 12 months and 24 months assess the frequency of gout attacks, the presence of tophi, comorbidity, medication use, quality of life, diet and lifestyle. The questionnaires in between only assess the frequency of gout attacks and medication use for gout. Descriptive statistics will be used to calculate the mean frequency of self-reported gout attacks during the 2-year follow-up. The propensity score for each patient being offered allopurinol is estimated and used to match patients with and without allopurinol treatment. We will compare the frequency of gout attacks in these groups using multilevel Poisson regression analyses. With this type of analysis, we can calculate the corrected estimated effect of allopurinol on gout attack frequency. ETHICS AND DISSEMINATION: The research protocol was approved by the Medical Ethical Committee of the Erasmus Medical Centre in Rotterdam. The knowledge generated by this study will be transferred to the Dutch College of General Practitioners, conferences and to (inter)national peer-reviewed journals. TRIAL REGISTRATION NUMBER: NTR6329; Pre-results. BMJ Publishing Group 2018-11-25 /pmc/articles/PMC6254413/ /pubmed/30478125 http://dx.doi.org/10.1136/bmjopen-2018-024335 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle General practice / Family practice
van Leeuwen, Kevin D B
Bohnen, Arthur M
Jacobs, Marloes L
van Der Lei, Johan
Janssens, Hein J E M
Koffeman, Aafke R
Bindels, Patrick J E
Bierma-Zeinstra, Sita M A
Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
title Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
title_full Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
title_fullStr Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
title_full_unstemmed Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
title_short Patient-reported gout attack frequency and allopurinol use in general practice in the Netherlands: a prospective observational cohort study protocol
title_sort patient-reported gout attack frequency and allopurinol use in general practice in the netherlands: a prospective observational cohort study protocol
topic General practice / Family practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6254413/
https://www.ncbi.nlm.nih.gov/pubmed/30478125
http://dx.doi.org/10.1136/bmjopen-2018-024335
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