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  • What We've Learned
Improving gout care: Shared access to electronic medical records
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Scientific Study Title:
Improving gout care: Shared access to electronic medical records
Start Date:
  • 2015
End Date:
  • 2019
Research Category
Tags
Mary De Vera, Research Team Member, Arthritis Research Canada
Mary De Vera
MSc, PhD, Associate Director of Training, Senior Scientist, Pharmacoepidemiology
J. Antonio Aviña-Zubieta, Research Team Member, Arthritis Research Canada
J. Antonio Aviña-Zubieta
Senior Scientist, Rheumatology, MD, MSc, PhD, FRCP

Why did we do this research?

Reason For Research

Gout is a very painful type of arthritis that occurs when too much uric acid builds up in the body, leading to repeated inflammation and deformity in the joints. It affects over 1 million Canadians, which is expected to increase as the population ages. Studies have shown that gout often is not properly managed or patients do not stick to their treatment plan. As a result, patients often do poorly, suffering from repeated gout attacks, and complications that lead to extra hospital visits, higher costs and even death. There is little research showing how to solve this problem. In this sub-project of the PRECISION study, we evaluated an eHealth-supported, decentralized care model for gout. A team of healthcare providers—including rheumatologists, pharmacists, and dietitians- supported patients who participated. Our goal was to see if this model could help patients manage their gout more effectively, particularly in lowering their serum urate levels, and to understand patients’ experiences with this care approach. We also wanted to know how patients actually become engaged in managing their gout, from their own perspectives.

What did we do?

Execution of Research

We conducted a 12-month study with 35 patients who had experienced at least one gout flare in the past year and had elevated serum urate levels. The care model involved community-based rheumatologists who provided support on an as-needed basis, monthly telephone consultations with a pharmacist, and one telephone consultation with a dietitian. These healthcare professionals were not located in the same place but had shared access to the patients’ electronic medical records (EMRs) to communicate and collaborate remotely. We measured outcomes by checking if patients reached the target serum urate level of <360 μmol/L after 12 months. We also conducted interviews with some of the patients to gather their feedback on the care model.

To explore how patients become engaged in managing their gout care, we interviewed 12 people with gout who were part of testing the new eHealth-supported care model.

Related Publications

  • Howren A, Tsao NW, Choi HK, et al. eHealth-supported decentralized multi-disciplinary care for gout involving rheumatology, pharmacy, and dietetics: proof-of-concept study. Clin Rheumatol. 2020;39(4):1241-1249. doi:10.1007/s10067-019-04809-6
  • Howren A, Cox SM, Shojania K, Rai SK, Choi HK, De Vera MA. How patients with gout become engaged in disease management: a constructivist grounded theory study. Arthritis Res Ther. 2018;20(1):110. Published 2018 Jun 1. doi:10.1186/s13075-018-1608-x
  • https://www.arthritisresearch.ca/wp-content/uploads/BRIDGE.pdf

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