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

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.