The diagnosis and proper treatment for gout were described decades ago but these guides are not always realized in all the patients.
Objectives: To evaluate by a mail survey sent to general physicians (GP), internal medicine physicians (IM), orthopedists (OP) and rheumatologists (RP) from Mexico city, the way they diagnose and treat gouty patients.
Subjects and methods: The survey was anonymous and included 20 questions, it was sent by mail to 1,836 physicians (640 GP, 640 OP, 423 IM and 133 RP) living in Mexico city.
Results: The response was 6.8% OP, 10.4% IM, 10.8% GP and 41.4% RP. Eighty two to 95% of them attend gouty patients. Diclofenac was the drug most frequently used as the treatment for acute attacks, although a high frequency of glucocorticoids and allopurinol prescription for acute gout attacks was detected (28% OP and 49% GP respectively). Allopurinol is the drug more frequently used for the chronic treatment, it is also used for asymptomatic hyperuricemia by 43-84% of the physicians. Twenty five percent do not adjust initial allopurinol doses to glomerular filtration rate. The prophylactic treatment is used in only some cases and the dietetic restrictions were variable. Some points regarding the treatment of these patients are not according those recommended in the literature.
Conclusions: We need to increase the knowledge between physicians about gout diagnosis and proper treatment. The adequate treatment is in most of the cases safe, cheap and effective.