SAT0412 DOES THERAPEUTIC EDUCATION IMPROVE GOUT MANAGEMENT: THE EXPERIENCE OF LARIBOISIERE UNIVERSITY HOSPITAL PARIS-FRANCE
Authors: Omar Al Tabaa, Etienne Gaix-Fontaine, Julia Herrou, Frederic Lioté, Thomas Bardin, Pascal Richette, Aline Frazier, Hang Korng Ea
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Gout is a frequent and curable arthritis affecting 0.9% of adults in France. Its management remains suboptimal and less than one third of patients have efficient urate-lowering treatment (ULT). However, when individualized information were given and patients engaged in their care a treat-to-target strategy permits to achieve serum urate level (SU) at target (SU &lt; 360 μmol/L) in more than 95% of patients. Therapeutic education sessions (TES) may improve patient knowledges, gout flare and ULT management. <h3>Objectives:</h3> To assess the percentage of patients achieving SU target at 1 year after a TES. <h3>Methods:</h3> TES was set up in the department since January 2014. Patients willing to participate to TES responded to a questionnaire and were interviewed with a nurse assessing their knowledges, believes and gout representations. Each TES included 5 to 8 patients and was conducted according to participants' needs. We retrospectively included all patients who had attended one TES between 1<sup>st</sup>January 2014 and 31<sup>th</sup>December 2017 and who had at least one visit between 9 and 15 months later. TES patients were matched in 1:1 with no-TES patients regarding age, sex and referent practitioner. For all patients were collected: demographics, disease duration, SU, treatments and comorbidities (type 2 diabetes, chronic kidney disease, hypertension, and cardiovascular diseases). <h3>Results:</h3> Overall, 54 TES patients were included and matched with 54 non-TES patients. Patients' characteristics (demographics, disease duration, SU, treatments and comorbidities) were similar at baseline except for the body mass index (BMI) and the follow-up. BMI was higher (31.0 ± 5.7 vs 28.4 ± 5.0 kg/m<sup>2</sup>, p=0.03) and the final visit shorter (11 ± 3.6 vs 14.4 ± 4.8 months, p=0,001) in no-TES patients than in TES patients, respectively. At final visit, 36 TES patients (67%) and 34 no-TES patients (63%) reached the SU target (&lt; 360 μmol/L) (p=0.84) (Table 1). Moreover, 22 (41%) TES patients and 18 (33%) no-TES patients had a final SU &lt; 300 μmol/L (p=0.43). There were no differences between groups (TES vs no-TES patients respectively) for: final SU (342 μmol/l ± 94 vs 338 ± 71, p=0.84), ULT (89% vs 96%, p=0.16), ULT dosage and hyperuricemic therapy (15% vs 11%, p=0.77). <h3>Conclusion:</h3> The percentage of patients achieving SU target after one single TES was high compare to literature data. However, it was not different from usual care achieved in our department, a tertiary care center expert in gout management. The diffusion of our <i>savoir-faire</i> and the TES will improve gout management. <h3>Reference</h3> [1] Doherty M, Jenkins W, Richardson H, Sarmanova A, Abhishek A, Ashton D, et al. Efficacy and cost-effectiveness of nurse-led care involving education and engagement of patients and a treat-to-target urate-lowering strategy versus usual care for gout: a randomised controlled trial. The Lancet. 2018;392(10156):1403–1412. <h3>Disclosure of Interests:</h3> Omar Al Tabaa: None declared, Etienne Gaix-Fontaine: None declared, Julia Herrou: None declared, Frederic Lioté Grant/research support from: institutional grants from Grunenthal, Ipsen Pharma/Menarini, Novartis, SOBI for the European Crystal Network Workshops, Consultant for: Grunenthal, Novartis, Thomas Bardin Consultant for: Astrazeneca, Grunenthal, Horizon, Novartis, Speakers bureau: Astella, AstraZeneca, Grunenthal., Pascal Richette Consultant for: Grunenthal, Horizon, Speakers bureau: AstraZeneca, Grunenthal, Aline Frazier: None declared, Hang Korng Ea: None declared