Dispensed a non-steroidal anti-inflammatory drug without urate-lowering therapy

Description

This measure shows the percentage of people with identified gout who were dispensed funded non-steroidal anti-inflammatory drugs (NSAIDs) but not dispensed urate-lowering therapy. While it is not known whether it was gout that led to an NSAID being dispensed, high rates of NSAID dispensing without urate-lowering therapy use may reflect people using NSAIDs to manage their acute gout flares. International best practice indicates that people experiencing frequent gout flares (two or more per year) should be offered long-term urate-lowering therapy. Large variation may reflect patient preference and/or variable clinical practice.

Measure set

Gout domain

Notes about this measure set

Note that the NSAID dispensing may not necessarily be related to gout symptoms.

Numerator

People with identified gout aged 20 years and over dispensed publicly funded non-steroidal anti-inflammatory drug (NSAID) in a year but not dispensed gout-specific urate-lowering therapy (ULT; allopurinol, febuxostat or benzbromarone) in the same year.

Denominator

Those aged 20 years and over identified with gout using the HealthTracker method (see gout prevalence numerator definition).

Denominator detail

NSAIDs included were: diclofenac sodium, ibuprofen, ketoprofen, mefenamic acid, meloxicam, naproxen, naproxen sodium, tenoxicam, celecoxib and sulindac.
This measure only includes NSAIDs dispensed at community pharmacies, ie, not medicines given in hospital or purchased over the counter.
Gout-specific urate-lowering therapy: 1026 allopurinol, 4026 febuxostat, 3754 and 4003 benzbromarone.
Only those enrolled with a PHO in each year were included.

Denominator exclusions