Front-line Management of Gout: A Step-by-Step Guide to Best Practice

Program Overview:
Gout is the most common cause of inflammatory joint disease in men over 40 years and both the incidence and prevalence of gout are increasing. A survey in 2002 estimated that 5 million Americans are affected by gout with approximately 3.9 million annual clinician visits, two-thirds being to primary care clinicians, who are responsible for the management of the vast majority of patients with uncomplicated gout. Moreover, patients with gout have a poor quality-of-life with greater functional limitations and higher mortality than the general population.

This activity will provide primary care healthcare providers with a concise, step-by-step guide to the latest information, tempered with expert opinion, on the modern approaches to the diagnosis and management of gout. This will include both nonpharmacologic (lifestyle) and pharmacologic approaches to the treatment of acute gout flares and to long-term management. The importance of counseling patients on their commitment to adhering to long-term lifestyle and drug treatment recommendations will be a key focus.

Learning Objectives:
After completing this activity, the participant will be able to

1. Identify that the long-term goal of gout treatment is to reduce serum urate to <6.0 mg/dL and to define the key steps in selecting and individualizing urate-lowering therapy according to the disease stage, together with recognizing the importance of monitoring serum urate levels
2. Educate patients that an important factor in successful management includes their long-term commitment to adherence with the recommended lifestyle and drug interventions

Accreditation/Designation Statement:
Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Target Audience:
This activity is targeted to all physicians and other healthcare professionals who treat patients with gout.

Release Date: January 26, 2010
Expiration Date: January 26, 2011

Medium: Online CME

Acknowledgment of Commercial Support:
This activity was developed from the live Best Practices in Primary Care™ program held in Rosemont, Illinois, on November 20, 2009 and is funded by TPNA Pharmaceuticals, Inc.

Method of Participation:
To receive CME credit for this activity, you need to review the program (slides and audio). Upon finishing the online CME, complete the post-test and evaluation, and fill out all required personal information. To receive your CME certificate you will need to pass the post-test with 70% accuracy or better.

Post-test and Evaluation:
After completing this activity, click on the Post-test button at the end of the program. If you receive less than 70% on the post-test, you will be returned to the beginning of the activity to review the presentation again. Upon successful completion of the post-test, you will be asked to fill out a program evaluation form and prompted to print your CME certificate.

Statement of Disclosure and Independence
It is the policy of Primary Care Network, Inc. to ensure all its sponsored educational activities are planned, developed, and conducted in accordance with the ACCME’s Essential Areas and Policies. In accordance with ACCME requirements, Primary Care Network has Conflict of Interest and Disclosure Policies that are designed to ensure that Primary Care Network sponsored educational activities are fair balanced, independent, evidence‐based and based on scientific rigor.

Primary Care Network’s Resolution of Personal Conflicts of Interest (COI) Policy aims to ensure that all conflicts are resolved prior to the activity, content is developed and presented free of commercial bias, and is in the interest of promoting improvements or quality in healthcare. All individuals who are in a position to influence and/or control content of a Primary Care Network sponsored activity are required to disclose to the participants any real or apparent conflict of interest related to the activity. The educational content is also reviewed for independence and content validation by an independent external clinical reviewer and internal clinical reviewer. Independence is also monitored through the activity and overall program evaluation process.

The opinions, ideas, recommendations, and perspectives expressed in the accompanying presentations at this Primary Care Education program are those of the program authors and presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations or perspectives of their affiliated institutions, Primary Care Network, Primary Care Education, Advisory Boards and Consultants, or the activity’s commercial supporters.

Faculty and Disclosures

D. Wayne Bell, MD
Family Practitioner, Bowling Green Family Care Center
Medical Director, Diabetes Day Care Center
Wood County Hospital
Bowling Green, OH

Dr. Bell serves on the speaker’s bureau for Eli Lilly, GlaxoSmithKline, Roche, and
sanofi-aventis; he also serves on advisory boards for GlaxoSmithKline and Roche.

Robert A. Terkeltaub, MD
VA Rheumatology Section Chief
Professor of Medicine, University of California, San Diego
San Diego, CA

Dr. Terkeltaub has received research grant support from Takeda and is a consultant for BioCryst, EnzymeRx, Novartis, Pfizer, Prescription Solutions, Regeneron, Savient, Takeda, UCB, and URL.

Planning Committee and Disclosures

Robert A. Terkeltaub, MD has received research grant support from Takeda and is a consultant for BioCryst, EnzymeRx, Novartis, Pfizer, Prescription Solutions, Regeneron, Savient, Takeda, UCB, and URL.

Alison Howe has no relevant financial relationships to disclose.
Managing Director, Strategic Consultants International
Hemel Hempstead, Herts, UK

Alka Amin has no relevant financial relationships to disclose.
Senior Associate Project Director, Strategic Consultants International
Hemel Hempstead, Herts, UK

Vicki Evans has no relevant financial relationships to disclose.
Project Manager, Strategic Consultants International
Hemel Hempstead, Herts, UK

Review Committee Disclosure
In accordance with PCN policy, all content is reviewed by external independent peer reviewers for balance, objectivity and commercial bias.  The peer reviewers, staff, and other individuals who control content have no relevant financial relationships to disclose.

Unlabeled Use Declaration