A Patient/Rheumatologist/Pharmacist/Dietician Team Use Electronic Communication To Better Manage Gout

 

Scientific study title:

Collaborative Care Involving eHealth* to Improve Treatment Adherence and Health Outcomes of Patients with Gout

*eHealth refers to the use of technologies to manage information and communications in health care.  The use of eHealth practices can facilitate communications between practitioners and patients and allow for better management and sharing of electronic medical records.  

 

 

Study Start Date:

July 2014

Study End Date:

January 2017

 

Why Did We Do This Research?

Gout is a very painful type of arthritis that occurs when too much uric acid builds up in the body leading to inflammation and deformity in the joints. It affects over one million Canadians and this burden is expected to increase with the aging of the population. Studies have shown that gout is often poorly managed and patients do not always follow their treatment plans and take their medication. As a result, patients often do poorly, suffering from repeated gout attacks, and complications that lead to avoidable emergency department visits and hospitalizations. Research on how to optimize and improve gout care is very limited.

 

What Did We Do?

The Virtual Gout Clinic is a collaborative care team for gout involving rheumatology, pharmacy, and dietetics. The clinic takes advantage of eHealth technologies particularly shared access of electronic medical records (EMR).

Participants with gout received:
      • regular in person visits with their rheumatologist;
      • monthly medication management telephone calls with the pharmacist; and
      • one phone counselling session with the dietician.
Outcome measures include:
      • Disease activity, functional status, and quality of life as measured through online surveys.
      • Medication adherence and serum uric acid levels assessed via the shared EMR.

 

Who Was Involved?

We have a team consisting of researchers, eight rheumatologists in four participating practices across British Columbia, a registered dietician, and a study pharmacist. Those with gout treated by the study rheumatologists are invited to participate. Altogether, 35 individuals with gout have been enrolled in the study and received care within this eHealth-supported collaborative care clinic.

 

 

The Research Team

Principal investigator:

Mary De Vera, MSc, PhD, Senior Scientist, Pharmacoepidemiology, Associate Director of Training, Arthritis Research Canada (University of British Columbia)

Co-Investigators:

Kamran Shojania, MD, FRCPC, Clinical Trialist, Rheumatology, Arthritis Research Canada (University of British Columbia)

Carlo Marra, BSc (Pharm), PharmD, PhD, Research Scientist, Pharmacoepidemiology, Arthritis Research Canada (University of Otago)

Hyon Choi, MD, DrPH, FRCPC, Research Scientist, Rheumatology, Arthritis Research Canada (Harvard Medical School)

J. Antonio Avina-Zubieta, MD, MSc, PhD, FRCPC, Senior Scientist, Rheumatology, Arthritis Research Canada (University of British Columbia)

Alison Kydd, MD, Clinical Assistant Professor, University of British Columbia Milton Baker, MD, FRCPC, Associate Member, Division of Rheumatology, (University of British Columbia)

 

Who Funded This Research?

Canadian Initiatives for Outcomes in Rheumatology Care (CIORA) and Canadian Institutes of Health Research (CIHR)