The aim is to evaluate if the patients who are receiving Allopurinol for gout prophylaxis have had their serum urate (uric acid) checked within 3 months of a change in dose or prescription. We should aim for uric acid concentration less than 300 micromol/L. If the guideline was not implemented, analysing the reason and suggesting improvements for future practice will be included.

DescriptionThe aim is to evaluate if the patients who are receiving Allopurinol for gout prophylaxis have had their serum urate (uric acid) checked within 3 months of a change in dose or prescription. We should aim for uric acid concentration less than 300 micromol/L. If the guideline was not implemented, analysing the reason and suggesting improvements for future practice will be included.

Objectives (how you will achieve your aim): I will do a retrospective search for patients on Allopurinol who are receiving this medication for Gout prophylaxis. I will include patients who were prescribed Allopurinol after 10.3.2019. I will exclude patients who are receiving Allopurinol for chemotherapy or kidney stones. I will check how many patients have had their uric acid levels checked within three months of prescription or dose change. I will also check if the practice has aimed for uric acid under 300 micromol/L.

2 MAIN CRITERION:

1. All patients who suffer from recurrent Gout and are prescribed Allopurinol for it, should have their Uric Acid (Urate) checked within 3 months to check the new level. 90% Evidence shows elevated uric acid levels result in Urate crystal formation which in turn results in acute gout. According to NICE guideline, Allopurinol is the first-line Urate-lowering agent for gout prophylaxis. This is because it is highly effective and inexpensive. Once Allopurinol has been started, NICE recommends to check Urate levels within the first 3 months. However, in practice, there might be some limitations to achieving this which will be addressed in the audit. For example: patients declining to come in to check their Uric Acid levels if the prescribed dose is working well for them.

2. whether the patients are meeting the target uric acid level of less than 300micromol/L. 100% According to NICE guideline, the practice should aim for blood uric acid below 300 micromol/L.

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I can measure how well the guideline is being implemented and if it’s not, why. The initial search includes 46 patients. Within this population I am going to exclude the patients who are receiving Allopurinol for conditions other than Gout. I believe it is realistic to pick this population as it is representative of the overall population as well.

Attachment:

Ssc guides + clinical audit+ assessment ) plz read these first

Ssc examplar is the perfect version of the audit provided by the university.

There is also ssc example same topic which is an example of a pass with the same topic to mine. However, I am aiming for a merit so better structure, discussion and overall grade is what I want.

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