Knowledge and practice of gout treatment recommendations by primary health care physicians in Saudi Arabia: A cross-sectional study across five different regions

Gout, the most common inflammatory arthritis in developed countries, can lead to deformities and disabilities, significantly affecting quality of life. Primary care physicians (PCPs) play a crucial role in its management and must adhere to recent guidelines. This study assessed PCPs' knowledge and adherence to gout treatment recommendations in Saudi Arabia using a questionnaire survey. A total of 367 PCPs completed the survey, with 86.4% practicing in Saudi Arabia. The respondents included general physicians (53.1%) and family physicians (49.9%), with a nearly equal gender distribution. For acute gout management, 25.34% recommended nonsteroidal anti-inflammatory drugs combined with corticosteroids. Colchicine was considered safe by 69.8% of participants. Knowledge of urate-lowering therapy was suboptimal, with only 7.9% correctly identifying the appropriate initiation timing and 43.1% recognizing the target serum uric acid (SUA) level. While 74.1% recommended modifying therapy if the SUA target was unmet, only 32% advocated for long-term urate-lowering therapy. Additionally, 18% correctly identified the proper time to measure SUA levels. Lifestyle modifications were acknowledged by 57.2%, and 55% recognized the cardiovascular risks associated with gout. Overall, PCPs demonstrated poor compliance with gout management guidelines. Strategies to improve adherence include continuing medical education, disease-management websites, and smartphone apps. Rheumatologists should serve as key resources for PCPs, providing education through consultations, formal training, and conference presentations.