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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-104Improving Treat-To-Target for Gout in Primary Care Health Clinics in GombakDistrictJazlan J1, Musbahiyah MZ2, Zamrina A2, Sharifah Syadiyah SS3, Siti Khamsiah AS4, Arputajulie A4,Chow PL5, Noorul Amilin S5, Anjhana S6, Chang LC7, Zamzurina A7, Izyana Syazlin I8, Koh WM8, SarahCCJ8, Juliana Idora AJ1, Lalitha Ambigai V1, Nor Anizah M9, Noor Azlina N4, Tan YJ9, Amy FairuzaAA10, Rosnah MI10, Siti Nur Hidayah AR10, Siti Saleha AR10, Thien KN101 Klinik Kesihatan Selayang Baru, Selangor2 Klinik Kesihatan AU2, Selangor3Klinik Kesihatan Batu 8, Selangor4 Klinik Kesihatan Batu Arang, Selangor5Klinik Kesihatan Gombak Setia, Selangor6 Klinik Kesihatan Hulu Kelang, Selangor7Klinik Kesihatan Kuang, Selangor8Klinik Kesihatan Rawang, Selangor9 Klinik Kesihatan Sungai Buloh, Selangor10 Klinik Kesihatan Taman Ehsan, SelangorSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Gout, the most common inflammatory arthritis, affects 0.1% to 6.8% of people globally and is linked withhigher mortality and reduced quality of life. Urate-lowering treatments can prevent crystal formation anddissolve existing crystals, making gout the only arthritis where the pathogenic agent can be eliminated. InMalaysia, only 34.9% of gout patients in a hospital study reached the target serum urate (SU) levels, withnonadherence (52.3%) being the primary cause of failure.KEY MEASURES FOR IMPROVEMENT:This study aimed to improve the percentage of patients with gout prescribed with allopurinol achievingthe treatment target of SU <360 %u03bcmol/L in Gombak District health clinics.PROCESS OF GATHERING INFORMATION:A retrospective review of medical records from January 1st to December 31st, 2023 and patients withgout were identified based on clinical diagnosis, SU, and prescribed medications. Data was analysedusing Microsoft Excel and compared to the 2021 Malaysian Clinical Practice Guideline (CPG) for goutmanagement.ANALYSIS AND INTERPRETATION:A total of 111 patients were included, with 87.4% being males. All clinics met the criteria for structure. Atdiagnosis, 17.9% underwent recommended initial investigations. Allopurinol was prescribed to 84.4% ofeligible patients within one year. Regular tests every six months were conducted for 34.2% of patients onallopurinol. Lipid and diabetes testing was conducted in 90.9% of patients, but only 11.7% achieved targetSU levels. 84.6% of patients needing specialised care were referred appropriately. Based on the results,the low achievement of SU is likely due to treatment inertia and non-adherence to CPG.STRATEGIES FOR CHANGE:To improve the low treatment success rate for gout, we developed practical interventions with multiplecomponents. We adapted a gout management algorithm and patient information leaflets based on theCPG, planned to conduct refresher training for medical officers and create video counselling through QRcodes to support self-management and adherence.196 | Page