Evidence map›Paper›PMID 31720913›Full record

ArticleClinical rheumatology2020

eHealth-supported decentralized multi-disciplinary care for gout involving rheumatology, pharmacy, and dietetics: proof-of-concept study.

Alyssa Howren, Nicole W Tsao, Hyon K Choi, Kam Shojania, Alison Kydd, Russell Friesen, J Antonio Avina-Zubieta, Mary A De Vera

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 17 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Alyssa HowrenFaculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Nicole W TsaoFaculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
Hyon K ChoiArthritis Research Canada, Richmond, BC, Canada.
Kam ShojaniaArthritis Research Canada, Richmond, BC, Canada.
Alison KyddFaculty of Medicine, Department of Medicine, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada.
Russell FriesenProvidence Health, Vancouver, BC, Canada.
J Antonio Avina-ZubietaArthritis Research Canada, Richmond, BC, Canada.
Mary A De VeraFaculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada. mdevera@mail.ubc.ca.ORCID http://orcid.org/0000-0002-2205-2683
University of British Columbia · CAHarvard University · USProvidence Health Care · CA

Funding

Canadian Initiative for Outcomes in Rheumatology Care N/ACIHR FRN#THC-135235
6 · The paper itself

Abstract

objectiveTo conduct quantitative and qualitative evaluation of an electronic health (eHealth)-supported decentralized multi-disciplinary care model for gout involving rheumatologists, pharmacist, and dietitian.

methodsWe 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. Healthcare 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 subset of patients and applied constructivist grounded theory to gather patients' perspectives.

resultsOverall, 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.

conclusionOur 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.Key Points• We demonstrated the feasibility and impact of an eHealth-supported, decentralized collaborative care model for gout involving rheumatology, pharmacy, and dietetics• Although prior multi-disciplinary models of care for gout have been reported, the novelty of our model is that healthcare providers are not co-located, lending to potential efficiencies and outreach to patients in rural areas.

Indexed as

Health Knowledge, Attitudes, PracticeAgedFemaleGoutGrounded TheoryHumansInterviews as TopicMaleMiddle AgedNutritionistsPatient Care TeamPatient Education as TopicPharmacistsProof of Concept StudyQualitative ResearchRheumatologistsDieteticsGoutModels of carePharmacyRheumatology

Identifiers

PMID31720913
OpenAlexW2988431467

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.