Gout

• Can I talk to a doctor on Gotodoctor.ca about gout?

Yes, Gotodoctor.ca provides virtual care services for gout. A doctor will take a comprehensive in-depth history and may provide you with prescriptions. Depending on the severity of symptoms further recommendations will be provided. The doctor will direct him/her to clinic treatment depending on symptoms.

• What is gout?

Gout is a form of arthritis characterized by swelling of joints. It causes chronic inflammation and can cause irreversible joint damage, permanent bone deformation and stiffness^[1]. Increased uric acid levels in the blood stream leads to accumulation of uric crystals at the sites of involved joint with structural damage^[2].

• What are the symptoms of gout?

Gout can be presented with pain in one or more joints and effusion in and around the involved joint^[3]. Complications of gout involve hyperuricemia, kidney stones and uric acid nephropathy, severe degenerative arthritis, fracture in involved joints with tophaceous gout^[4]. Untreated gout may lead to deposition of uric acid beneath the skin nodules labelled as tophi^[5-7]. Doctor will be able to diagnose gout at the clinic by identifying characteristic symptoms. 

• How is gout treated?

A doctor decides on treatment after taking a comprehensive history of the patient. Treatment of gout pain depends on the investigation findings, such as blood screening test for uric acid levels. Pain relief medications and uric acid lowering drugs may be prescribed^[8]. Prescriptions for corticosteroids may be provided at the clinic and through virtual care services^{[9] [10, 11]}. Diet modifications may also be prescribed to lower the level of uric acid in plasma^[12].

• How can an online doctor on Gotodoctor.ca treat gout?

Online doctor on Gotodoctor.ca treat gout through virtual care services. An appointment can be easily made with an online doctor. Gout can be treated via virtual care methods^{[10, 11, 13-19]}. An online doctor will take a comprehensive history of your signs and symptoms and may provide you with prescriptions. Prescriptions can be obtained by online doctors. Virtual care services provided by Gotodoctor.ca assure comfort, convenience and a higher level of care for the patient.

References

1. Terkeltaub, R.A., Gout. New England Journal of Medicine, 2003. 349(17): p. 1647-1655.
2. Neogi, T., Gout. New England Journal of Medicine, 2011. 364(5): p. 443-452.
3. Choi, H.K., D.B. Mount, and A.M. Reginato, Pathogenesis of gout. Annals of internal medicine, 2005. 143(7): p. 499-516.
4. Roddy, E. and H.K. Choi, Epidemiology of gout. Rheumatic Disease Clinics, 2014. 40(2): p. 155-175.
5. Arromdee, E., et al., Epidemiology of gout: is the incidence rising? The Journal of rheumatology, 2002. 29(11): p. 2403-2406.
6. TALBOTT, J.H. and K.L. TERPLAN, The kidney in gout. Medicine, 1960. 39(4): p. 469-526.
7. Weaver, A.L., Epidemiology of gout. Cleveland Clinic journal of medicine, 2008. 75: p. S9-12.
8. Goldfien, R., et al., A pharmacist-staffed, virtual gout management clinic for achieving target serum uric acid levels: a randomized clinical trial. The Permanente Journal, 2016. 20(3).
9. Leonardo, N., et al., Review of gout clinic in a tertiary hospital setting. Internal medicine journal, 2020. 50(1): p. 117-120.
10. Almathami, H.K.Y., K.T. Win, and E. Vlahu-Gjorgievska, Barriers and Facilitators That Influence Telemedicine-Based, Real-Time, Online Consultation at Patients’ Homes: Systematic Literature Review. J Med Internet Res, 2020. 22(2): p. e16407.
11. Deldar, K., K. Bahaadinbeigy, and S.M. Tara, Teleconsultation and Clinical Decision Making: a Systematic Review. Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH, 2016. 24(4): p. 286-292.
12. Reaves, E. and B. Arroll, Management of gout in a South Auckland general practice. Journal of primary health care, 2014. 6(1): p. 73-78.
13. Gunasekeran, D.V., et al., Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial. Journal of medical Internet research, 2020. 22(6): p. e17417-e17417.
14. Myers, D.R., et al., Towards remote assessment and screening of acute abdominal pain using only a smartphone with native accelerometers. Scientific Reports, 2017. 7(1): p. 12750.
15. Staub, G., J. Overbeck, and E. Blozik, Teleconsultation in children with abdominal pain: A comparison of physician triage recommendations and an established paediatric telephone triage protocol. BMC medical informatics and decision making, 2013. 13: p. 110.
16. Bokolo Anthony, J., Use of Telemedicine and Virtual Care for Remote Treatment in Response to COVID-19 Pandemic. Journal of Medical Systems, 2020. 44(7): p. 132.
17. Eaton, L.H., et al., Development and implementation of a telehealth-enhanced intervention for pain and symptom management. Contemporary clinical trials, 2014. 38(2): p. 213-220.
18. Wang, X., et al., Impact of Telemedicine on Healthcare Service System Considering Patients’ Choice. Discrete Dynamics in Nature and Society, 2019. 2019: p. 7642176.
19. Williams, O.E., et al., The use of telemedicine to enhance secondary care: some lessons from the front line. Future healthcare journal, 2017. 4(2): p. 109-114.