{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:42:30Z","timestamp":1783604550920,"version":"3.55.0"},"reference-count":28,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2013,11,8]]},"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The study objective was to determine the feasibility of using a pharmacist-staffed, protocol-based structured approach to improving the management of chronic, recurrent gout.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The study was carried out in the outpatient clinic of a single Kaiser Permanente medical centre. This is a community-based clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>We report on 100 consecutive patients between the ages of 21 and 94 (75% men) with chronic or recurrent gout, referred by their primary physicians for the purpose of management of urate-lowering therapy. Patients with stage 5 chronic kidney disease or end-stage kidney disease were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>The programme consisted of a trained clinical pharmacist and a rheumatologist. The pharmacist contacted each patient by phone, provided educational and dietary materials, and used a protocol that employs standard gout medications to achieve and maintain a serum uric acid (sUA) level of 6\u2005mg\/dL or less. Incident gout flares or adverse reactions to medications were managed in consultation with the rheumatologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Primary outcome measure<\/jats:title><jats:p>The primary outcome measure was the achievement and maintenance of an sUA of 6 or less for a period of at least 3\u2005months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 95 evaluable patients enrolled in our pilot programme, an sUA of 6\u2005mg\/dL or less was achieved and maintained in 78 patients with 4 still in the programme to date. Five patients declined to participate after referral, and another 13 patients did not complete the programme. (The majority of these were due to non-adherence.)<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A structured pharmacist-staffed programme can effectively and safely lower and maintain uric acid levels in a high percentage of patients with recurrent gout in a primary care setting. This care model is simple to implement, efficient and warrants further validation in a clinical trial.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2013-003627","type":"journal-article","created":{"date-parts":[[2014,1,11]],"date-time":"2014-01-11T02:04:54Z","timestamp":1389405894000},"page":"e003627","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Effectiveness of a pharmacist-based gout care management programme in a large integrated health plan: results from a pilot study"],"prefix":"10.1136","volume":"4","author":[{"given":"Robert D","family":"Goldfien","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele 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