{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T13:57:53Z","timestamp":1762955873413,"version":"build-2065373602"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,10,26]],"date-time":"2018-10-26T00:00:00Z","timestamp":1540512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To pilot a primary care gout management improvement intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two large primary care sites were selected: 1 underwent the intervention, the other, a control, underwent no intervention. The intervention consisted of engagement of intervention\u2010site staff, surveys of provider performance improvement preferences, and onsite live and enduring online education. Electronic health record reminders were constructed. Both the intervention and control sites had 3 quality measures assessed monthly: the percentage of gout patients treated with urate\u2010lowering therapy, the percentage of treated patients monitored with serum urate, and the percentage of treated patients at target serum urate \u22646.0 mg\/dl. The intervention\u2010site providers received monthly reports comparing their measures against their peers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>By 6 months, the intervention site significantly improved all 3 gout performance measures. The percentage treated increased from 54.4% to 61.1% (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 1.19 [95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.08\u20131.31]; <jats:italic>P<\/jats:italic> &lt; 0.001), the percentage monitored increased from 56.1% to 79.2% (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.52 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.24\u20131.87]; <jats:italic>P<\/jats:italic> &lt; 0.001), and the percentage at goal increased from 26.85% to 43.3% (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.43 [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.16\u20131.77]; <jats:italic>P<\/jats:italic> &lt; 0.001). At 6 months after intervention, gout patients at the intervention site were more likely to be monitored (79.2% versus 53.4% [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.54 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.30\u20135.45)]; <jats:italic>P<\/jats:italic> &lt; 0.001) and at goal (43.3% versus 28.3% [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.99 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.33\u20132.96)]; <jats:italic>P<\/jats:italic> &lt; 0.001) than control\u2010site patients. Numbers treated did not significantly improve over the control site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A pilot multifaceted gout management program can significantly improve primary care gout management performance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.23544","type":"journal-article","created":{"date-parts":[[2018,2,13]],"date-time":"2018-02-13T16:58:37Z","timestamp":1518541117000},"page":"1679-1685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Improved Gout Outcomes in Primary Care Using a Novel Disease Management Program: A Pilot Study"],"prefix":"10.1002","volume":"70","author":[{"given":"David","family":"Bulbin","sequence":"first","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0531-3503","authenticated-orcid":false,"given":"Alfred E.","family":"Denio","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Berger","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Brown","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carson","family":"Maynard","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarun","family":"Sharma","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. Lester","family":"Kirchner","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William T.","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Geisinger Medical Center Danville Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30520"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(03)80158-3"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2659"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22767"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.02.004"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.3517"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(84)90743-5"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4065\/81.7.925"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30119"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.34488"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22469"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21773"},{"key":"e_1_2_6_15_1","unstructured":"National Quality Forum.NQF\u2010endorsed measures for musculoskeletal conditions: technical report January 30 2015. 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