Perspectives on the Management of Hyperuricemia and Gout in Older Adults

Various comorbidities and extensive medication regimens often complicate the management of gout in older adults. Even in the general population, managing gout can be challenging, as clinicians must develop strategies for acute gout treatment, assess the need for chronic management, and optimize prophylaxis for gout flares. Several factors influence the choice of pharmacologic therapy, including the patient's medical history, current medications, social and family history, ethnicity, age, and care preferences. This article reviews gout management with a focus on older adults through a case study approach, highlighting the importance of shared decision-making. The integration of pharmacists into direct patient care introduces a novel model of pharmacist-led gout management, which can improve adherence to urate-lowering therapy and optimize medication selection. Despite the rising prevalence of gout, it remains one of the most poorly managed diseases. This review aims to emphasize key principles for effective and safe gout management, taking into account the comorbidities and medications commonly encountered in the older adult population.