Category: Federal Forum Posters
Purpose: Many patients with gout should be treated with urate-lowering therapy (ULT) to prevent gout flares. ULT should be titrated based on uric acid (UA) levels every 2 to 5 weeks until target UA is achieved. In 2016, the Pharmacy Gout Management Service was implemented at the VA Northeast Ohio Healthcare System. A quality improvement project conducted in 2016 evaluating this service identified that the average time between UA testing was 6 weeks. The purpose of this process improvement project is to standardize the Pharmacy Gout Management Service to reduce time to UA laboratory testing while patients are undergoing ULT titrations.
Methods: To increase the percentage of patients who obtain UA laboratory testing within 2 to 5 weeks, Lean Six Sigma methodology will be utilized to systematically evaluate the gout monitoring process and to identify process defects that may result in untimely monitoring. This investigation will include patients enrolled in the Pharmacy Gout Management Service via colchicine non-formulary drug requests. The primary metric will be percentage of patients who obtain UA laboratory testing within 2 to 5 weeks from enrollment into the Pharmacy Gout Management Service. Time to first UA laboratory testing after enrollment into the Pharmacy Gout Management Service will retrospectively be collected as baseline data. Baseline data will be used to identify process defects and to subsequently implement improvements to optimize and standardize gout management. The effectiveness of improvements will be tracked over time by evaluating time to first UA laboratory test after enrollment into service, time between subsequent UA laboratory tests, time to UA target achieved, time to discontinuation of colchicine therapy, and pharmacist time spent on gout monitoring. Improvement in gout management will lead to decreased duration of colchicine therapy, decreased acute gout flares, and decreased pharmacist time spent on gout management.
Results: Not applicable
Conclusion: Not applicable
Kaci Kehrt– PGY2 Ambulatory Care Pharmacy Resident, VA Northeast Ohio Healthcare System, Cleveland, OH