ArticleBMC rheumatology2026
Performance of a supervised nurse-led outpatient clinic for difficult-to-manage gout patients at a tertiary center.
Article in BMC rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundGout is among the most prevalent arthritides worldwide and is associated with high morbidity, cardiovascular risk, and substantial healthcare burden. Despite effective urate-lowering therapies (ULT), many patients remain undertreated, particularly those with severe or complex disease. Nurse-led gout management has improved outcomes in primary care, but data in multimorbid tertiary center populations are lacking. We aimed to evaluate the effectiveness of a supervised nurse-led gout clinic in achieving and maintaining serum urate (SU) targets in a tertiary hospital cohort.
methodsIn this observational study at the University Hospital (Inselspital) Bern we report on the performance during May 2023 and Jan 2026 in 69 patients with confirmed gout per a restricted panel of EULAR/ACR 2015 classification criteria. Patients were assigned to SU targets of ≤ 300 µmol/L (group 1: severe gout) or ≤ 360 µmol/L (group 2: non-severe gout). An Advanced Practice Nurse (APN) provided education, a rheumatologist provided pharmacological management per 2016 EULAR/ACR guidelines. SU levels, flare frequency, prophylaxis, and treatment adjustments were monitored, with follow-up at six and twelve months.
resultsGroup 1 required higher allopurinol doses than group 2 (p ≤ 0.01). SU targets were achieved in 80% of group 1 regimens and 68% of Group 2. Flare rates and prophylaxis use were comparable. At six/twelve months follow-up, 62/67% of group 1 and 85/88% of group 2 maintained SU targets. Failures were often due to external treatment modifications. No major ULT-related adverse events were observed.
conclusionSupervised nurse-led gout management effectively achieves SU targets in this difficult-to-manage cohort. Maintaining SU targets may benefit from shorter follow-up intervals and enhanced education for patients and healthcare providers.
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