{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:43:31Z","timestamp":1790981011131,"version":"4.1.0"},"reference-count":25,"publisher":"The Journal of Rheumatology","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2024,11,8]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Following Health Canada\u2019s knowledge translation framework, we report the results of a clinical audit from 2012 to 2015 followed by a multidisciplinary, nurse-led gout care protocol with a treat-to-target (T2T) strategy implemented in April 2018.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A clinical audit with chart reviewing was completed for adults with gout and urate-lowering therapy (ULT) indication at the Centre Hospitalier Universitaire de Sherbrooke. A nurse-led treatment algorithm using allopurinol was then developed. Titration of ULT by a nurse every 4 weeks was done until serum uric acid (SUA) target. In the postprotocol implementation, adults with gout and ULT indication were retrospectively recruited through a billing agency until December 2020. The main outcome was SUA target achievement at 6 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 50 patients identified in the audit, 31% reached SUA target at 6 months and 16% were lost to follow-up. A 74-patient postprotocol implementation cohort was recruited, with 43 in the protocol group and 31 under usual care. Most prevalent ULT indication was \u2265 2 gout attacks per year (n = 52) at 70%. Target SUA was reached in 65% (n = 28) in the protocol group at 6 months compared to 19% (n = 6) in the usual care group (<jats:italic>P<\/jats:italic>&lt; 0.001). Failing to titrate medication in the usual care group was the leading cause for nonachievement of SUA target at 6 months. Five percent of patients were lost to follow-up, all in the usual care group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A multidisciplinary, nurse-led protocol with a T2T strategy implemented after a clinical audit significantly improved gout care. Such protocol could be replicated elsewhere in Canada.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.2024-0707","type":"journal-article","created":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T13:25:15Z","timestamp":1733059515000},"page":"285-289","source":"Crossref","is-referenced-by-count":5,"title":["Improving Gout Care in a Canadian Academic Medical Center Through a Multidisciplinary, Nurse-Led Protocol"],"prefix":"10.3899","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7346-7730","authenticated-orcid":false,"given":"Thomas","family":"Audet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Aude","family":"Picard-Turcot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Robindaine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Carrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5058-6941","authenticated-orcid":false,"given":"Pierre","family":"Dagenais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2024,12,1]]},"reference":[{"key":"2025041108350694000_52.3.285.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-0441-1"},{"key":"2025041108350694000_52.3.285.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2016.08.006"},{"key":"2025041108350694000_52.3.285.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2203385"},{"key":"2025041108350694000_52.3.285.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.12.005"},{"key":"2025041108350694000_52.3.285.5","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac706"},{"key":"2025041108350694000_52.3.285.6","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201687"},{"key":"2025041108350694000_52.3.285.7","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25167"},{"key":"2025041108350694000_52.3.285.8","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-016-1211-y"},{"key":"2025041108350694000_52.3.285.9","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2020.00244"},{"key":"2025041108350694000_52.3.285.10","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150310"},{"key":"2025041108350694000_52.3.285.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.09.007"},{"key":"2025041108350694000_52.3.285.12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.7812\/TPP\/15-234","article-title":"A pharmacist-staffed, virtual gout management clinic for achieving target serum uric acid levels: a randomized clinical trial","volume":"20","author":"Goldfien","year":"2016","journal-title":"Permanente J"},{"key":"2025041108350694000_52.3.285.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32158-5"},{"key":"2025041108350694000_52.3.285.14","doi-asserted-by":"publisher","DOI":"10.3109\/03009742.2012.689325"},{"key":"2025041108350694000_52.3.285.15","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13855"},{"key":"2025041108350694000_52.3.285.16","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2024-004179"},{"key":"2025041108350694000_52.3.285.17","first-page":"575","article-title":"Nurse-led care is preferred over GP-led care of gout and improves gout outcomes: results of Nottingham Gout Treatment Trial follow-up study","volume":"59","author":"Fuller","year":"2020","journal-title":"Rheumatology"},{"key":"2025041108350694000_52.3.285.18","first-page":"529","article-title":"Long-term persistence and adherence on urate-lowering treatment can be maintained in primary care-5-year follow-up of a proof-of-concept study","volume":"56","author":"Abhishek","year":"2017","journal-title":"Rheumatology"},{"key":"2025041108350694000_52.3.285.19","unstructured":"Government of Canada . 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