Objective To evaluate the impact of incorporating treatment guidance into reporting of urate test results. Methods Urate targets for clinically confirmed gout were added to urate results above 0.36 mmol/l requested after September 2014 within NHS Lothian. Scotland-wide data on urate-lowering therapy prescriptions and hospital admissions with gout were analysed between 2009 and 2020. Local data on urate tests were analysed between 2014 and 2015. Results Admissions with a primary diagnosis of gout in Lothian reduced modestly following the intervention from 111/year in 2010–2014 to 104/year in 2015–2019, a non-significant difference (P = 0.32). In contrast there was a significant increase in admissions to remaining NHS Scotland health boards (556/year vs 606/year, P < 0.01). For a secondary diagnosis of gout the number of admissions in NHS Lothian reduced significantly (58/year vs 39/year, P < 0.01) contrasting with a significant increase in remaining Scottish health boards (220/year vs 290/year, P < 0.01). The relative rate of admissions to NHS Lothian compared with remaining Scottish boards using a 2009 baseline were significantly reduced for both primary diagnosis of gout (1.06 vs 1.25, P < 0.001) and secondary diagnoses of gout (0.64 compared with 1.4, P < 0.001) after the intervention; however, there was no difference before the intervention. A relative increase in the prescription rates of allopurinol 300 mg tablets and febuxostat 120 mg tablets may have contributed to the improved outcomes seen. Conclusion Incorporation of clinical guideline advice into routine reporting of urate results was associated with reduced rates of admission with gout in NHS Lothian, in comparison with other Scottish health boards.

中文翻译：

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将痛风指南建议纳入尿酸盐报告与减少住院率有关：一项观察性研究的结果

目的评估将治疗指导纳入尿酸盐检测结果报告的影响。方法 2014 年 9 月 NHS Lothian 要求的尿酸结果高于 0.36 mmol/l 时，将临床确诊痛风的尿酸目标值添加到该结果中。在 2009 年至 2020 年期间，分析了苏格兰范围内关于降尿酸治疗处方和因痛风住院的数据。在 2014 年至 2015 年期间分析了当地的尿酸盐检测数据。结果 在洛锡安的主要诊断为痛风的入院人数在洛锡安的干预后适度减少2010-2014 年为 111 个/年，2015-2019 年为 104 个/年，差异不显着（P = 0.32）。相比之下，其余 NHS 苏格兰卫生委员会的入院人数显着增加（556 人/年 vs 606 人/年，P < 0.01）。对于痛风的二次诊断，NHS Lothian 的入院人数显着减少（58 人/年 vs 39 人/年，P < 0.01），而其余苏格兰卫生委员会的人数显着增加（220 人/年 vs 290 人/年，P < 0.01） ; 0.01)。与使用 2009 年基线的其他苏格兰委员会相比，NHS Lothian 的相对入院率在痛风的主要诊断（1.06 与 1.25，P < 0.001）和痛风的次要诊断（0.64 与 1.4，P < 0.001）方面均显着降低。 0.001) 干预后；但是，干预之前没有区别。别嘌醇 300 毫克片剂和非布索坦 120 毫克片剂的处方率相对增加可能有助于改善所见的结果。