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eHealth Supported Decentralized Multi-Disciplinary Care for Gout Involving Rheumatology, Pharmacy, and Dietetics : Proof-of-concept Study Howren, Alyssa; Tsao, Nicole W.; Choi, Hyon; Shojania, Kam; Kydd, Alison; Friesen, Russell; Aviña-Zubieta, J. Antonio; De Vera, Mary
Abstract
Objective: To conduct quantitative and qualitative evaluation of an electronic health (eHealth)-supported decentralized multi-disciplinary care model for gout involving rheumatologists, pharmacist, and dietitian. Methods: We conducted a 12-month proof-of-concept study. Gout patients with ≥1 flare in the past year and serum urate (SUA) ≥360 μmol/L within the previous 2 months were followed by participating community rheumatologists on an as needed-basis, received monthly telephone consults with a pharmacist, and one telephone consult with a dietitian. Health care professionals were not co-located but had shared access to the rheumatologists’ electronic medical records (EMR) for remote communication and collaboration. In quantitative evaluation, the primary outcome was the proportion of patients with SUA <360 μmol/L at 12 months. In qualitative evaluation, we conducted semi-structured interviews with a sub-set of patients and applied constructivist grounded theory to gather patients’ perspectives. Results: Overall, 35 gout patients (86% males, mean age 60.9 ± 14.9 years) participated. At 12 months, 72% of patients achieved target SUA <360 μmol/L. Qualitative analysis of interviews with a subset of 12 patients resulted in two themes: 1) experiences with receiving care, including categories of improved knowledge about gout, receiving personalized support, and knowing someone cares; and 2) practical considerations, including categories of optimizing timing of care and coordination and accessibility. Conclusion: Our multi-method study shows that a decentralized, multi-disciplinary care for gout involving rheumatology, pharmacy, and dietetics with shared EMR access led to gout patients achieving target SUA. It was well-received by patients who perceived better education about gout and personalized care.
Item Metadata
Title |
eHealth Supported Decentralized Multi-Disciplinary Care for Gout Involving Rheumatology, Pharmacy, and Dietetics : Proof-of-concept Study
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Alternate Title |
eHealth supported multi-disciplinary care for gout
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Creator | |
Date Issued |
2019-11-13
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Description |
Objective: To conduct quantitative and qualitative evaluation of an electronic health (eHealth)-supported decentralized multi-disciplinary care model for gout involving rheumatologists, pharmacist, and dietitian. Methods: We conducted a 12-month proof-of-concept study. Gout patients with ≥1 flare in the past year and serum urate (SUA) ≥360 μmol/L within the previous 2 months were followed by participating community rheumatologists on an as needed-basis, received monthly telephone consults with a pharmacist, and one telephone consult with a dietitian. Health care professionals were not co-located but had shared access to the rheumatologists’ electronic medical records (EMR) for remote communication and collaboration. In quantitative evaluation, the primary outcome was the proportion of patients with SUA <360 μmol/L at 12 months. In qualitative evaluation, we conducted semi-structured interviews with a sub-set of patients and applied constructivist grounded theory to gather patients’ perspectives. Results: Overall, 35 gout patients (86% males, mean age 60.9 ± 14.9 years) participated. At 12 months, 72% of patients achieved target SUA <360 μmol/L. Qualitative analysis of interviews with a subset of 12 patients resulted in two themes: 1) experiences with receiving care, including categories of improved knowledge about gout, receiving personalized support, and knowing someone cares; and 2) practical considerations, including categories of optimizing timing of care and coordination and accessibility.
Conclusion: Our multi-method study shows that a decentralized, multi-disciplinary care for gout involving rheumatology, pharmacy, and dietetics with shared EMR access led to gout patients achieving target SUA. It was well-received by patients who perceived better education about gout and personalized care.
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Subject | |
Genre | |
Type | |
Language |
eng
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Date Available |
2020-11-13
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Provider |
Vancouver : University of British Columbia Library
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Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
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DOI |
10.14288/1.0388563
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URI | |
Affiliation | |
Citation |
Howren A, Tsao NW, Choi HK, Shojania K, Kydd A, Friesen R, Avina-Zubieta JA, De Vera MA. eHealth-supported decentralized multi-disciplinary care for gout involving rheumatology, pharmacy, and dietetics: proof-of-concept study. Clin Rheumatol. 2019 Nov 13.
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Publisher DOI |
10.1007/s10067-019-04809-6
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Peer Review Status |
Reviewed
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Scholarly Level |
Faculty; Graduate
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Rights URI | |
Aggregated Source Repository |
DSpace
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Item Citations and Data
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International