DOI: 10.36347/sjams.2017.v5i08.026

Pages: 3092-3095

Gout is one of the most common diseases in the population. Its management begins first of all with the general practitioner. This management has been the subject of recommendations by international learned societies such as EULAR (European League Against Rheumatisms). The objective is to evaluate the level of concordance between the management of gout in general practice and the EULAR recommendations. A questionnaire based on six fictitious clinical cases was mailed to 99 general practitioners in the city of Marrakech. Clinical cases have dealt with the treatment of the gout attack, hypouricemic treatments (dosage, prescribing procedures), treatment of secondary gout with diuretics and hygiene-dietetic rules. Our study involved 99 general practitioners based in Marrakech, either in the private sector or in the public sector. We had a response rate of 73%. For first-line treatment of gout access, 95% of physicians prescribe colchicine and / or nonsteroidal anti-inflammatory drugs (NSAIDs). In 8% of cases, oral corticosteroids were used. In the case of side effects to colchicine, 51% of general practitioners reduce the colchicine dose by half. The rest stops it and replace it with NSAIDs or analgesics. Regarding the prescription of allopurinol, 18% of doctors believe that it is systematic from the first access. To judge the efficacy of allopurinol, the intended biological threshold of uric acid was correct (uricemia <60 mg / l) in 71,20%. At initiation of treatment with allopurinol, 33% co-prescribed colchicine to prevent recurrence of the attacks. Finally, 75% of general practitioners advise on hygiene-dietetic rules. Treatment of gout is poorly consistent with EULAR recommendations.