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Improved Gout Outcomes in Primary Care Using a Novel Disease Management Program: A Pilot Study.

David Bulbin1, Alfred E Denio1, Andrea Berger1

  • 1Geisinger Medical Center, Danville, Pennsylvania.

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A pilot gout management intervention significantly improved care quality in primary care settings. The program enhanced monitoring and goal achievement for gout patients, demonstrating effective quality improvement strategies.

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Area of Science:

  • Rheumatology
  • Primary Care Medicine
  • Quality Improvement

Background:

  • Gout management in primary care often falls short of evidence-based guidelines.
  • Effective interventions are needed to improve the quality of gout care in primary care settings.

Purpose of the Study:

  • To pilot a multifaceted intervention aimed at improving gout management within primary care.
  • To assess the impact of the intervention on key quality performance measures for gout patients.

Main Methods:

  • A pilot study was conducted at two large primary care sites, with one site receiving the intervention and the other serving as a control.
  • The intervention included staff engagement, provider preference surveys, live and online education, and electronic health record (EHR) reminders.
  • Key performance measures (percentage treated with urate-lowering therapy, percentage monitored for serum urate, and percentage at target serum urate ≤6.0 mg/dl) were assessed monthly.

Main Results:

  • The intervention site showed significant improvements in all three quality measures within six months.
  • Percentage of patients treated increased from 54.4% to 61.1% (P < 0.001).
  • Percentage monitored increased from 56.1% to 79.2% (P < 0.001), and percentage at goal increased from 26.85% to 43.3% (P < 0.001).
  • At six months post-intervention, intervention-site patients were more likely to be monitored and at goal compared to control-site patients (P < 0.001 for both).

Conclusions:

  • A pilot multifaceted gout management program can significantly enhance primary care gout management performance.
  • The intervention demonstrated success in improving monitoring and achievement of target serum urate levels.
  • Further research may explore strategies to improve the percentage of patients treated with urate-lowering therapy.