Efficacy and Outcomes of a Novel Telephone-based Gout Disease Management Program

Abstract

Objective: Gout is the most common inflammatory arthritis in the United States. Despite published guidelines, management remains suboptimal, leading to unnecessary morbidity and increased cost of care. We have designed the gout disease management program (GDMP) to improve outcomes, increase patient satisfaction and decrease healthcare utilization.Methods: Gout patients were seen at their usual rheumatology clinical visit and offered participation in the GDMP. Data were collected between April 2017 and May 2019. Serum uric acid (SUA) levels were measured at initial outpatient encounter, at entrance to GDMP and every 4 weeks until SUA was at goal of ≤6 mg/dl. During telephone encounters, gout-related recent hospitalizations and ER or urgent care visits since last encounter were ascertained. Self-reported gout medication usage and adherence were also determined. Patient satisfaction with GDMP was surveyed using a 5-point Likert scale.Results: A total of 158 patients were enrolled, of which 112 had ≥ 1 telephone encounter and were included in our analyses. During the telephone phase, 79 patients (70%) achieved SUA goal of ≤6.0 mg/dl, while90 patients (80%) achieved an acceptable SUA of ≤6.5 mg/dl. Only 3 patients (2.6%) required hospitalization or visits to an ER or urgent care center due to gout flare, and 98% rated their encounter as a 5 on the 5-point Likert scale.Conclusion: Our telephone-based management program for gout led to improved clinical outcomes as defined by the ACR guidelines, decreased healthcare visits, and had high patient satisfaction.