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General practitioners' perspectives on the management of gout: a qualitative study
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    Emphasis on Lifestyle Management Not Evidence Based

    I read with interest the manuscipt by Jeyaruban and colleagues. However I am disappointed that a major issue identified was a "Failure of adherence to lifestyle changes".

    There is scant evidence that lifestyle changes have any clinically relevant impact on gout management.

    Surgical weight loss is one of the few non medication related interventions that has a substantial impact on serum urate.

    ...
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    Conflict of Interest:
    None declared.