# Knowledge, attitude and practice in managing patients with asymptomatic hyperuricaemia among primary care doctors in Malaysia: A cross-sectional study

## TL;DR

This study examines how primary care doctors in Malaysia manage asymptomatic hyperuricaemia, finding that while knowledge is high, practice is mixed and could be improved with better training and guidelines.

## Contribution

The study identifies gaps in managing asymptomatic hyperuricaemia among primary care doctors and highlights the role of rheumatology training in improving practice.

## Key findings

- Most primary care doctors have adequate knowledge of asymptomatic hyperuricaemia but lack confidence in guidelines.
- Only half of the doctors demonstrated adequate practice in managing asymptomatic hyperuricaemia.
- Prior rheumatology training significantly predicts better management practices.

## Abstract

The prevalence of hyperuricaemia is increasing worldwide. Hyperuricaemia is associated with many comorbidities, but care quality is suboptimal. This study aimed to determine the level of knowledge, attitude (perceived barrier) and practice in managing asymptomatic hyperuricaemia (AH) among primary care doctors (PCDs) and whether there is a significant difference between PCDs with and without postgraduate qualifications in Malaysia. It also aimed to determine the factors associated with adequate practice in managing AH.

A cross-sectional study was conducted using a validated online questionnaire. The adequacy of knowledge and practice was set at a score of >50%, and attitude (perceived barrier) was described in percentages. Multiple logistic regression examined the factors associated with adequate practice in managing AH.

A total of 412 PCDs participated, with the majority being women (76.2%) and Malay (74.0%) and working in public primary care clinics (84.0%). The overall mean knowledge score was 24.78 (standard deviation [SD] =3.01), and 96.4% achieved adequacy. For attitude, the most commonly perceived barriers were lack of knowledge about the disease (50%) and guidelines (48.5%). The overall mean practice score was 17.51 (SD=8.09), with 53.2% demonstrating adequate practice. Multivariate analysis identified prior rheumatology attachment as the only significant predictor of adequate practice in managing AH (aOR=1.778, 95% confidence interval=1.083-2.920; P<0.005).

Despite high knowledge levels, a substantial proportion of PCDs report inadequate understanding of AH and its guidelines. Addressing these barriers through targeted educational interventions, guideline dissemination and specialised training, including rheumatology exposure, may enhance AH management in primary care.