Beyond medicines for gout Question Title * What is your occupation? Business or Funding Manager Community pharmacy - Assistant Community pharmacy - Head Pharmacist Community pharmacy - Pharmacist Community pharmacy - Pharmacist and Prescriber Community pharmacy - Pharmacist Intern Community pharmacy - Pharmacist Locum Community pharmacy - Pharmacy Facilitator Community pharmacy - Technician Community pharmacy - Manager Education or Quality Professional General Practice - Assistant General Practice Manager General Practitioner General Practitioner Locum General Practitioner Registrar (GPTP) Health Consultant Hospital or Other Clinician Media or Communications Professional Nurse - Primary Care (Practice) Nurse Practitioner - Diabetes Nurse Practitioner - Other Nurse Practitioner - Primary Care Nurse Practitioner - Respiratory/Asthma Nurse Practitioner - Urgent Care Nurse Prescriber - Designated Nurse Prescriber - Primary Care Urgent Care Practitioner Student Question Title * 1. Which TWO of the following statements are CORRECT? Prevalence of identified gout in 2019 in Māori and Pacific peoples was about twice and three times, respectively, that of non-Māori, non-Pacific peoples Over 2016–2020, Māori and Pacific peoples started preventive gout medicine, on average, about 10–13 years later than non-Māori, non-Pacific peoples Māori and Pacific men, not women, are disproportionately affected with gout compared with non-Māori, non-Pacific men and women NSAIDs were dispensed at higher rates in 2019 in Māori and Pacific peoples identified with gout, compared with non-Māori/non-Pacific peoples Once over the age of 65, the prevalence of gout is generally the same in Māori and Pacific peoples and non-Māori, non-Pacific peoples Question Title * 2. Which THREE of the following are risk factors (not triggers) for gout? Alcohol Ethnicity Increasing age Injury Male gender Shellfish Question Title * 3. Which THREE of the following are comorbidities associated with gout? Hypothyroidism Diabetes Renal impairment Asthma Hypertension Osteoarthritis Alcoholism Question Title * 4. What is the most effective way for people with gout to achieve long-term symptom control? Lifestyle and dietary changes Regular and consistent use of urate-lowering therapy Treatment with repeated courses of NSAIDs Treatment with colchicine, as it is effective and specific for gout Question Title * 5. When should you provide understandable medicine and lifestyle advice and education to people with gout? At allopurinol initiation Every time allopurinol is dispensed/prescribed When there is a flare occurrence When working towards stabilisation on long-term treatment All of the above Question Title * 6. In Māori and Pacific peoples, when should preventive urate-lowering therapy be discussed? At the first gout flare At the second gout flare If acute treatment is not effective If two gout flares have occurred in one year Question Title * 7. Earlier prescribing of urate-lowering therapy to Māori and Pacific peoples is needed to achieve equitable care. True or False? True False Question Title * 8. Different management approaches are needed to provide optimal gout screening/treatment. Which THREE of the approaches below are likely to provide the most benefit to Māori and Pacific peoples? Have more pharmacies provide faster delivery of NSAIDS using technology (eg, drone networks) Promote social marketing and mana-enhancing messaging about getting screened for gout/taking gout medicines (eg, sporting hero advocates) Increase the number of urate-lowering medicine prescriptions written by GPs Involve patients’ whānau in gout patients’ management so they feel encouraged to ask and have their questions answered in a non-deficit manner Undertake annual health promotion days in the community Make low-dose NSAIDs freely available for no cost Use a multidisciplinary approach (eg, GPs, nurses, pharmacists, health improvement practitioners, health coaches) Question Title * 9. When should allopurinol be stopped? During an acute gout flare If a flare occurs after the first year of treatment, indicating allopurinol is ineffective If a rash appears, as it may be due to allopurinol hypersensitivity syndrome If renal function declines Once no flares have occurred over a two-year period When the serum urate level is at target Question Title * 10. Which statement regarding allopurinol is CORRECT? When initiating allopurinol prophylactic cover against gout flares should be continued for at least six months regardless of serum urate levels Allopurinol should be stopped during a gout flare Allopurinol interacts with warfarin and diuretics Allopurinol should be taken regularly and consistently for 12 months initially and then its requirement reassessed, especially if OTC NSAIDs are readily available Allopurinol should not be initiated during a gout flare Question Title * 11. Which of the following acute treatments for gout is associated with gastrointestinal bleeding, renal impairment and increased cardiovascular risk? Colchicine NSAIDs Prednisone Question Title * 12. Which TWO of the following statements regarding acute treatments for gout flares are CORRECT? Toxic colchicine overdose occurs with only a small number of tablets Prednisone is not suitable for people with impaired renal function There is little difference in effectiveness between colchicine, prednisone and NSAIDs NSAIDs should not be used for at least three months following myocardial infarction Done