Available via license: CC BY 4.0
Content may be subject to copyright.
Phone, D 2017 Owning My Gout- A Pharmacist-led collaborative gout
management model at Counties Manukau DHB.
International Journal of
Integrated Care
, 18(S1): A38, pp. 1-8, DOI: dx.doi.org/10.5334/ijic.s1038
CONFERENCE ABSTRACT
Owning My Gout- A Pharmacist-led collaborative gout management model at
Counties Manukau DHB
1st Asia Pacific Conference on Integrated Care, Brisbane, 06-08 Nov 2017
Diana Phone
Ko Awatea, Counties Manukau DHB, New Zealand
Introduction: Gout is a chronic condition caused by excess monosodium urate crystal
deposition in and around joints, ligaments and tendons. It causes painful inflammation and
swelling, limits function and has a negative impact on quality of life.
Gout affects over 15,000 people over the age of 15 in the Counties Manukau region
Men, Maori and Pacific people most affected
Average of 360 hospital admissions/ year at Middlemore Hospital due to gout
Estimated cost of admissions being around $1,152,000 per year
Short description of practice change implemented: Gout management involves treatment of
an acute attack, lifestyle modification and urate lowering treatment to achieve a target level.
Community Pharmacists are ideally placed to work in collaboration with GP’s and patients to
improve the management of diagnosed gout, through the ordering of urate levels, ensuring
dose titration of allopurinol and providing self- management advice to patients.
Aim and theory of change: The aim of OMG is to develop a collaborative model of care where
the patients, their GP, nurses and pharmacists will work together to:
Titrate allopurinol to achieve serum urate levels below target (0.36mmol/L)
Improve adherence to treatment and lifestyle modifications.
Targeted population and stakeholders:
Targeted population: Patients with gout
Stakeholders: Community pharmacists, GP, nurses, Ko Awatea and Counties Manukau District
Health Board
Timeline: This project started mid-2014, and has really gained momentum over the last 12
months.
Highlights (innovation, impact and outcomes): Results so far have been promising, with three
GP’s and three pharmacies providing this service to seventy patients across the region. In
August, 3 new pharmacies and general practices will start piloting this model of care.
2
Phone; Owning My Gout- A Pharmacist-led collaborative gout management model at
Counties Manukau DHB
Achievements to date:
Pharmacists working at top of scope of practice
Three general practices and three pharmacies providing service to seventy patients
Statistically significant reduction in serum urate levels of enrolled patients
Translation of Stop Gout Booklet into Mandarin, Samoan and Tongan
Counties Manukau DHB has approved funding for 6 pilot pharmacies (at
$27.70/patient/month) to provide the service for one year starting July 2017.
Positive feedback from patients, nurses and GPs.
A model that supports collaboration between patients, GPs, nurses and pharmacists.
Comments on sustainability: Once training has been provided, and the model implemented it is
able to be sustained by the pharmacy/GP. For this work to spread further, a more sustainable
way of training will be needed (eg e-learning).
Comments on transferability: This community pharmacist-led service model is adaptable and
has the potential to be spread within Counties Manukau and nationally and also applied to
other chronic conditions
Conclusions: This gout management model has shown benefits to both patients and health care
providers and has great potential for spread
Keywords: gout; pharmacists; gps; nurses; collaboration