Oranga Rongo Papakura Marae Centre Figure 3 Male Diagnosed Gout - PowerPoint PPT Presentation

Oranga Rongoā Papakura Marae Centre

Figure 3 Male Diagnosed Gout Prevalence – by age and ethnicity National prevalence of gout derived from administrative health data in Aotearoa New Zealand Winnard D; Wright C; Taylor W; Jackson G; Te Karu L; Gow P; Arroll B; Thornley S; Gribben B; Dalbeth N Rheumatology 2012;51:901-9. 50% 50% 45% 45% 40% 40% 35% 35% 30% 30% 25% 25% 20% 20% 15% 15% 10% 10% 5% 5% 0% 0% 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85+ Years Years Years Years Years Years Years Years Years Years Years Years Years Years Asian Maori European/Other Pacific All

What is gout? Preventing What causes gout gout? Recognsing Talking to your family, signs and friends and symptoms of workmates gout attack Communicating Judging the with healthcare severity of professionals gout attack What to do for Access & cost a gout attack of healthcare (getting help) Gout Identifying C Demands Risk of causes of gout comorbidities attacks Uric acid target and The role of the monitoring kidneys (0.36) Purine rich The role of food and genes drinks Uric aciid medicines - 80/20 rule Medicines Medicines titration (serious side (types and effects) what they do)

Treatment to Target • Where we started • Today

Treatment to Target • Comparison • ~6 % of U.S Population have gout managed according to Guidelines (N. L Edwards Curr Rheumatol Rep (2011) 13:154–159) • 414 patients, 51% were treated with allopurinol 33.6% had ever had serum urate level tested 6.7% of people were achieving target serum urate levels (B. Arroll et al., 2011)

Treating with Allopurinol • Where we started • Today

Classification – from ...to

Patients with Gout classification on Allopurinol

Urate Testing

The next tier

Care planning • Improving health literacy • Cultural competency, • Motivational interviewing, • Having difficult conversations, • Recognising and acting on change talk. • Equalising power imbalances • Using technology to support patient education and information e.g. patient portal • Utilising patient stories and patient journeys

Patient Perspective • I don’t have gout • Haven't had gout for ages

Project Aim • Changes with patient input – Want easy access allopurinol – No flares