Project #140:
Incidence and management of gout during and before the COVID-19 pandemic

Rationale: Gout is by far the most common cause of inflamed joints worldwide, yet one of the worst managed. There are very effective medications that can prevent flares of pain and swelling in people with gout. However, previous studies have shown that patients with gout are often not prescribed these medications. National guidelines have been introduced with the aim of encouraging the optimal treatment of gout, but there remains very limited data on how care for people with gout has been affected by the COVID-19 pandemic or by the introduction of these guidelines.

Aim and Methods: Our goal is to use routinely collected data from electronic medical records through OpenSAFELY, to evaluate how the COVID-19 pandemic has impact on the quality of care for people with gout in England.

We will evaluate national and regional changes in several important aspects of care, which align with national recommendations, including: i) the number of new diagnoses of gout; ii) the prescription of guideline-recommended treatments; iii) the monitoring and attainment of treatment targets; iv) and the number of hospital admissions for gout flares.

We will investigate trends in these outcomes using interrupted time-series models, which will enable us to compare pre-pandemic, early pandemic and late pandemic phases.

Expected output of project: In the short term, this project will highlight areas for improvement at national and regional levels in England. In the long term, this routinely captured data will be used to monitor for improvements in care for patients with gout.