[These longstanding beliefs have been confirmed by some primary care teams (1) continuing to prescribe pain relief for acute attacks and primarily talking about dietary changes without discussing the causes and impacts of gout and benefits of long-term treatment.](https://healthnz.notion.site/These-longstanding-beliefs-have-been-confirmed-by-some-primary-care-teams-1-continuing-to-prescrib-f61af110a7904c6fad85176b1056c086)

[The stigma whānau Māori and Pacific peoples with gout experience in their community is also experienced and reinforced in health care settings (1). That’s why it’s important that all members of your team understand the relevant key messages and are empathetic when whānau Māori and Pacific peoples seek an appointment or present to your practice with an acute gout attack. You cannot understand how painful an acute gout attack is unless you have experienced one (6).](https://healthnz.notion.site/The-stigma-wh-nau-M-ori-and-Pacific-peoples-with-gout-experience-in-their-community-is-also-experien-93c6b7dec40b482290869a890ef72593)

(1) Humphrey C, Hulme R, Dalbeth N, Gow P, Arroll B, Lindsay K. A qualitative study to explore health professionals’ experience of treating gout: understanding perceived barriers to effective gout management (2016) JPHC 2016;8(2):149-156.

[Benecheck Point of Care meters are reliable when testing uric acid levels when titrating allopurinol and other uric acid lowering medicines (2)](https://healthnz.notion.site/Benecheck-Point-of-Care-meters-are-reliable-when-testing-uric-acid-levels-when-titrating-allopurinol-d8bb97ad8b9049e4be358a3796019c6a)

(2) Paraskos J, Berke Z, Cook J, Miner JN, Braddock M, Platt A, Hughes G. An analytical comparison between point-of-care uric acid testing meters. Expert Rev Mol Diagn. 2016;16(3):373-82. doi: 10.1586/14737159.2016.1134326. Epub 2016 Jan 11. PMID: 26689648

[We recommend that your team use the ‘Three Steps to Meeting Health Literacy Needs’ in conversations with whānau Māori and Pacific patients with gout. (3)](https://healthnz.notion.site/We-recommend-that-your-team-use-the-Three-Steps-to-Meeting-Health-Literacy-Needs-in-conversations--9f3ed8649884446daea1fc102c4e6baf)

(3) Three Steps to meeting health literacy needs | Ngā toru hīkoi e mōhiotia ai te hauora **Health Quality & Safety Commission Te Tāhū Hauora, NZ, 2022. **

[The table below contains examples of notes taken at a marae primary health clinic recording the various work situations that prevented whānau Māori and Pacific peoples with gout from accessing the clinic (4)](https://healthnz.notion.site/The-table-below-contains-examples-of-notes-taken-at-a-marae-primary-health-clinic-recording-the-vari-2e0e5583b1384cef9f6f7c571600f49b)

(4) Karu LT, Harwood M, Arroll B, Bryant L, Kenealy T. The inequity of access to health: a case study of patients with gout in one general practice NZ Med J. 2021;134(1543):51-58. PMID: 34695076

[Direct communication to a rheumatologist. (5)](https://healthnz.notion.site/Direct-communication-to-a-rheumatologist-5-bc78de5eacc14043bd85e18b36716596)

(5) Karu LT, Harwood M, Bryant L, Kenealy T, Arroll B. Compounding inequity: a qualitative study of gout management in an urban marae clinic in Auckland JPHC 2021;13:27-35.

[The stigma whānau Māori and Pacific peoples with gout experience in their community is also experienced and reinforced in health care settings (1). That’s why it’s important that all members of your team understand the relevant key messages and are empathetic when whānau Māori and Pacific peoples seek an appointment or present to your practice with an acute gout attack. You cannot understand how painful an acute gout attack is unless you have experienced one (6).](https://healthnz.notion.site/The-stigma-wh-nau-M-ori-and-Pacific-peoples-with-gout-experience-in-their-community-is-also-experien-93c6b7dec40b482290869a890ef72593)

(6) Lindsay, K, Gow P, Vanderpyl J, Logo, P, Dalbeth, N. The experience and impact of living with gout – a study of men with chronic gout using a qualitative grounded theory approach J Clin Rheum. 2011;17(1):1-6.

Gout initiatives in New Zealand

Aniva Lawrence; Sharon Scott; Fabio Saparelli; Georgina Greville; Andrew Miller; Andrea Taylor; Peter Gow Facilitating equitable prevention and management of gout for Māori in Northland, New Zealand, through a collaborative primary care approach (2019)11(2):117–127 J PRIM HEALTH CARE doi:10.1071/HC18082 https://www.publish.csiro.au/hc/pdf/HC18082