This paper describes an extreme burden of untreated gout arthritis in South Auckland. Transcripts of 11 semi-structured interviews conducted with male patients with gout were subjected to grounded theory qualitative analysis. Focus groups were held with health professionals involved in the provision of healthcare to patients with gout, patient and community groups, to validate the themes arising from the transcripts and to generate realistic recommendations to improve the quality of care for Māori and Pacific island patients with gout. The majority of patients were Māori or Pacific Island. The paper demonstrates that patients who are not successfully started on uricosuric treatment in primary care experience progressive disability and deterioration in other health parameters including weight gain, hypertension, and morbidity from nonuricosuric treatments such as anti-inflammatory medication, prednisone, and colchicine. The groups with the greatest burden of disease are the least likely to be started on treatment despite regular presentations to healthcare with exacerbations of increasing severity. The paper describes a huge impact on patients in terms of pain, disability, employment, and family members. Compliance is strongly linked to the quality of the information and depth of understanding of the patient.
