title: A Pharmacist-Staffed, Virtual Gout Management Clinic for Achieving Target Serum Uric Acid Levels: A Randomized Clinical Trial.
abstract: Relatively few patients with gout receive appropriate treatment.
  
  
  
  To determine whether a pharmacist-staffed gout management program is more effective than usual care in achieving target serum uric acid (sUA) levels in gout patients.
  
  
  
  A parallel-group, randomized controlled trial of a pharmacist-staffed, telephone-based program for managing hyperuricemia vs usual care. Trial duration was 26 weeks.
  
  
  
  Primary outcome measure was achieving sUA levels at or below 6 mg/dL at the 26-week visit. Secondary outcome was mean change in sUA levels in the control and intervention groups. Participants were adults with recurrent gout and sUA levels above 6.0 mg/dL. Participants were randomly assigned to management by a clinical pharmacist following protocol or to monitoring of sUA levels but management of their gout by their usual treating physician.
  
  
  
  Of 102 patients who met eligibility criteria, 77 subjects obtained a baseline sUA measurement and were entered into the trial. Among 37 participants in the intervention group, 13 (35%) had sUA levels at or below 6.0 mg/dL at 26 weeks, compared with 5 (13%) of 40 participants in the control group (risk ratio = 2.8, 95% confidence interval [CI] = 1.1 to 7.1, p = 0.03). The mean change in sUA levels among controls was +0.1 mg/dL compared with -1.5 mg/dL in the intervention group (sUA difference = -1.6, 95% CI = -0.9 to -2.4, p < 0.001).
  
  
  
  A structured pharmacist-staffed program was more effective than usual care for achieving target sUA levels. These results suggest a structured program could greatly improve gout management.
authors.affiliation: Chair of the Chiefs of Rheumatology for The Permanente Medical Group in Richmond, CA. robert.goldfien@kp.org.
authors.forename: Robert
authors.initials: R
authors.lastname: Goldfien
authors.affiliation: Director of Analytics and Evaluation in the Department of Research, Development, and Dissemination for Sutter Health in Walnut Creek, CA. pressmar@sutterhealth.org.
authors.forename: Alice
authors.initials: A
authors.lastname: Pressman
authors.affiliation: Senior Statistical Analyst in the Department of Research, Development, and Dissemination for Sutter Health in Walnut Creek, CA. jacobsa1@sutterhealth.org.
authors.forename: Alice
authors.initials: A
authors.lastname: Jacobson
authors.affiliation: Clinical Pharmacist in the Department of Outpatient Pharmacy at the Oakland Medical Center in CA. michele.s.ng@kp.org.
authors.forename: Michele
authors.initials: M
authors.lastname: Ng
authors.affiliation: Research Scientist at the Division of Research in Oakland, CA. andy.l.avins@kp.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Avins
mesh_terms: D005260:Female; D006073:Gout / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010595:Pharmacists; D024382:Professional Role; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid