Dispensed prednisone, colchicine or a non-steroidal anti-inflammatory drug without urate-lowering therapy

Description

This measure shows the percentage of people with identified gout who were dispensed any of colchicine, prednisone or funded non-steroidal anti-inflammatory drugs (NSAIDs), but not dispensed urate-lowering therapy in a year. Acute gout flares are treated with colchicine, oral corticosteroids such as prednisone or NSAIDs. This measure may reflect people experiencing acute gout flares who are not on long-term preventive therapy for gout. Gout management guidelines state that people experiencing frequent (two or more) acute gout flares per year should be offered long-term urate-lowering therapy. Although NSAIDs are effective at treating acute gout flares, these medicines have considerable side effects including kidney injury and peptic ulcer disease.

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 and dispensed any of colchicine, prednisone or funded non-steroidal anti-inflammatory drugs (NSAIDs) in a year but not dispensed gout-specific urate-lowering therapy (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

NSAID: Colchicine, prednisone, diclofenac sodium, ibuprofen, ketoprofen, mefenamic acid, meloxicam, naproxen, naproxen sodium, tenoxicam, celecoxib and sulindac.
Urate-lowering therapy: allopurinol, febuxostat and benzbromarone.
Only those enrolled with a PHO in each year were included.

Denominator exclusions