Management of gout in primary care of Hong Kong in accordance with international guidelines: any gaps to bridge?

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Kamsheung Chan, Catherine Xiaorui Chen, Lapkin Chiang, Kaming Ho, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4567784/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Feb, 2025 Read the published version in BMC Primary Care → Version 1 posted 3 You are reading this latest preprint version Abstract Background Gout is one of the most common conditions encountered in primary care. This study aims to assess urate control among gout patients managed in primary care settings and to evaluate its associated risk factors. Method Retrospective cross-sectional study. All adult Chinese gout patients who had been followed up in public primary care clinics from 1 January 2021 to 31 December 2021 were included. Patient demographics, clinical and biochemical parameters were retrieved from the computer system. Student’s t-test was used for analyzing continuous variables and Chi-square test was used for categorical data. Multivariate stepwise logistic regression was used to determine the associated risk factors for poor urate control. Results Among the 385 gout patients included, 115 met the target serum urate level (29.9%). All patients with tophaceous gout could not achieve the target serum urate level. In multivariate studies, male gender (OR 2.587, 95% CI: 1.374–4.873), active smoker (OR 3.170, 95% CI: 1.077–9.333), Chronic kidney disease with stage 3a, 3b and 4, (OR 3.236, 3.122 and 10.250 respectively, 95% CI: 1.556–6.732, 1.113–8.758 and 1.078–97.477 respectively) were less likely to meet the target urate level while those on urate-lowering agents (OR 0.225, 95% CI: 0.0.127–0.399) were more likely to meet the target urate level. Conclusion Only 29.9% of gout patients were adequately treated in public primary care settings in Hong Kong. Tophaceous gouty patients are found to have difficulties in achieving target serum urate level. Gout patients who were male, active smokers, having Chronic kidney disease with stage 3a, 3b and 4 were less likely to meet the target urate level while those on urate-lowering agents were more likely to meet the target urate level. Associated factor Chronic kidney disease Gout Hong Kong Primary care Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 12 Feb, 2025 Read the published version in BMC Primary Care → Version 1 posted Editor assigned by journal 24 Jun, 2024 Submission checks completed at journal 23 Jun, 2024 First submitted to journal 12 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4567784","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":319182809,"identity":"2dcfd1f4-fee1-47c4-ac75-42e9c80de2d9","order_by":0,"name":"Kamsheung Chan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2UlEQVRIiWNgGAWjYBACPmbmBgbGBgYGCQbmA0C+hAxBLWzMjDAtbAkgLTyEtTDAtfAYgASI0MLO2Cbxc4ddnmT/mc+vbtRY8DCwHz66gYDD2iR7zyQXS0vkbrPOOQZ0GE9a2g1CWqQZ25gT50nwbjPOYQNqkeAxI0ZLfeI8/jPPjHP+Ea/lcOJshhzmx7ltxGlptuxtO544c0aaGXNunwQPGyG/8PMfPnjjZ1t14ozzhx9/zvlWJ8fPfvgYXi1AwCIBsxHMYCOgHASYP6AzRsEoGAWjYBSgAACklkDqGnBMQAAAAABJRU5ErkJggg==","orcid":"","institution":"Queen Elizabeth Hospital","correspondingAuthor":true,"prefix":"","firstName":"Kamsheung","middleName":"","lastName":"Chan","suffix":""},{"id":319182810,"identity":"84f277b1-0e10-4baa-bc79-0ad8d5402f02","order_by":1,"name":"Catherine Xiaorui Chen","email":"","orcid":"","institution":"Queen Elizabeth Hospital","correspondingAuthor":false,"prefix":"","firstName":"Catherine","middleName":"Xiaorui","lastName":"Chen","suffix":""},{"id":319182811,"identity":"357e9a99-f293-4aec-bb36-817305d23146","order_by":2,"name":"Lapkin Chiang","email":"","orcid":"","institution":"Queen Elizabeth Hospital","correspondingAuthor":false,"prefix":"","firstName":"Lapkin","middleName":"","lastName":"Chiang","suffix":""},{"id":319182812,"identity":"73c4981f-aea4-4db4-b4fb-6f1af147f381","order_by":3,"name":"Kaming Ho","email":"","orcid":"","institution":"Queen Elizabeth Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kaming","middleName":"","lastName":"Ho","suffix":""},{"id":319182813,"identity":"15b32fa3-25f2-4566-8844-04f63709913f","order_by":4,"name":"Yimchu Li","email":"","orcid":"","institution":"Queen Elizabeth Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yimchu","middleName":"","lastName":"Li","suffix":""}],"badges":[],"createdAt":"2024-06-12 05:57:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4567784/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4567784/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12875-024-02664-2","type":"published","date":"2025-02-12T15:57:40+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":76488239,"identity":"913c2350-98b0-4396-aeb0-94f74de1861b","added_by":"auto","created_at":"2025-02-17 16:13:34","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":442436,"visible":true,"origin":"","legend":"","description":"","filename":"ManagementofgoutinprimarycareofHongKonginaccordancewithinternationalguidelinesanygapstobridge4.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4567784/v1_covered_9acd6d11-f845-4cf2-ba13-333cd5f19847.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Management of gout in primary care of Hong Kong in accordance with international guidelines: any gaps to bridge?","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Associated factor, Chronic kidney disease, Gout, Hong Kong, Primary care","lastPublishedDoi":"10.21203/rs.3.rs-4567784/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4567784/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGout is one of the most common conditions encountered in primary care. This study aims to assess urate control among gout patients managed in primary care settings and to evaluate its associated risk factors.\u003c/p\u003e\u003ch2\u003eMethod\u003c/h2\u003e \u003cp\u003eRetrospective cross-sectional study. All adult Chinese gout patients who had been followed up in public primary care clinics from 1 January 2021 to 31 December 2021 were included. Patient demographics, clinical and biochemical parameters were retrieved from the computer system. Student\u0026rsquo;s t-test was used for analyzing continuous variables and Chi-square test was used for categorical data. Multivariate stepwise logistic regression was used to determine the associated risk factors for poor urate control.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong the 385 gout patients included, 115 met the target serum urate level (29.9%). All patients with tophaceous gout could not achieve the target serum urate level. In multivariate studies, male gender (OR 2.587, 95% CI: 1.374\u0026ndash;4.873), active smoker (OR 3.170, 95% CI: 1.077\u0026ndash;9.333), Chronic kidney disease with stage 3a, 3b and 4, (OR 3.236, 3.122 and 10.250 respectively, 95% CI: 1.556\u0026ndash;6.732, 1.113\u0026ndash;8.758 and 1.078\u0026ndash;97.477 respectively) were less likely to meet the target urate level while those on urate-lowering agents (OR 0.225, 95% CI: 0.0.127\u0026ndash;0.399) were more likely to meet the target urate level.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOnly 29.9% of gout patients were adequately treated in public primary care settings in Hong Kong. Tophaceous gouty patients are found to have difficulties in achieving target serum urate level. Gout patients who were male, active smokers, having Chronic kidney disease with stage 3a, 3b and 4 were less likely to meet the target urate level while those on urate-lowering agents were more likely to meet the target urate level.\u003c/p\u003e","manuscriptTitle":"Management of gout in primary care of Hong Kong in accordance with international guidelines: any gaps to bridge?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-15 05:57:56","doi":"10.21203/rs.3.rs-4567784/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorAssigned","content":"","date":"2024-06-24T05:24:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-24T03:20:15+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Primary Care","date":"2024-06-12T05:55:50+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9ba764e9-591e-45e4-9499-ec4178d09f74","owner":[],"postedDate":"July 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-02-17T16:09:26+00:00","versionOfRecord":{"articleIdentity":"rs-4567784","link":"https://doi.org/10.1186/s12875-024-02664-2","journal":{"identity":"bmc-primary-care","isVorOnly":false,"title":"BMC Primary Care"},"publishedOn":"2025-02-12 15:57:40","publishedOnDateReadable":"February 12th, 2025"},"versionCreatedAt":"2024-07-15 05:57:56","video":"","vorDoi":"10.1186/s12875-024-02664-2","vorDoiUrl":"https://doi.org/10.1186/s12875-024-02664-2","workflowStages":[]},"version":"v1","identity":"rs-4567784","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4567784","identity":"rs-4567784","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}