A survey of gout within general practice in Great Britain

Currie, William Joshua Caddell (1978) A survey of gout within general practice in Great Britain. MD thesis, University of Glasgow.

Abstract

An epidemiological survey of gout has been conducted within general practice in Great Britain together with a study of the basis of diagnosis in, and the clinical profile of gout patients. In addition, observations have been made on the attitude of general practitioners to the concepts of gout and to the serum urate test. Data were obtained by means of questionnaires completed by doctors and their gout patients. A biochemical survey of the serum urate profile and the degree of hyperuricaemia within the general non-gout population also is included. Approximately 3, 000 blood samples from subjects without gout were obtained; the criteria covering their collection was laid down in a supplied protocol. Practices with a diagnostic index were selected to be, collectively, as closely representative of the national profile of general practice as possible. The prevalence of the diagnosis of gout in Great Britain was estimated to be 2. 6 per 1, 000 population which is in line with other European and North American figures. A significant regional variation was found, with a prevalence for England of 3. 0, for Wales 2. 1 and for Scotland 1.3 per 1,000. The incidence figures for each of the years 1971 - 1975 followed the same pattern. However, despite these differences the URATE levels were the same for the 3 countries. The reason for the different prevalences has not been fully elucidated, although some reasons have been examined and the work continues. The diagnosis of gout was almost invariably based on a typical acute joint episode or an appropriate history of such, with a confirmatory raised serum urate. Overall it would appear that the doctors believed the diagnosis and management of gout to be within the realms of general practice. The clinical profile showed a number of differences from previously published data based on hospital patients and a number of differences also were found in this survey, between the hospital referred and non-referred patients. In the present study 20% of the patients were referred to hospital and they were younger, more often had involvement of a joint other than in the great toe and were more liable to vascular disease. Thus, this survey of gout in general practice complements the hospital profile studies already reported and provides data on the frequency with which this problem is diagnosed within the British community.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Additional Information: Adviser: Patrick JS Hamilton
• Keywords: Medicine
• Date of Award: 1978
• Depositing User: Enlighten Team
• Unique ID: glathesis:1978-72096
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 17 May 2019 13:02
• Last Modified: 17 May 2019 13:02
• URI: https://theses.gla.ac.uk/id/eprint/72096