VA Office of Research and Development
This study will compare two different approaches to manage medications that lower uric acid levels. This study will be conducted at five VA medical centers across the United States and will take 4-5 years to complete. Individual participation will last up to two years.
This project will quantify and compare the effects of a pharmacist-led telehealth-delivered intervention versus usual care on arthritis flare burden and serum urate goal achievement in 310 U.S. Veterans with gout enrolled from five VA medical centers. The project will quantify the effects of the intervention on patient-reported outcomes (improvements in health-related quality of life, pain interference, and participant global assessment).
Inclusion Criteria: * US Veterans over the age of 18 years with physician-diagnosed * Documented hyperuricemia (SU \>6.8 mg/dL) * Satisfy ACR/EULAR gout classification criteria * Report 1 or more flares in the prior 6 months * Receipt of a new ULT prescription (allopurinol or febuxostat) initiated by a primary care provider or longer term ULT but otherwise satisfy the flare/SU criteria Exclusion Criteria: * Any patient intolerant or unable to take ULTs (allopurinol or febuxostat) * Patients with a rheumatology encounter within the prior 3 months
Pharmacist will conduct regular telehealth visits with Veterans during dose escalation phase of gout treatment