Gout

Click the links below to view each project:

• National Health Coalition/Papakura Marae Health Clinic (high-need population, consumer focus)
• Westbury Pharmacy and Hora Te Pai (integrated community pharmacist working as an in-practice clinical pharmacist)
• Health Literacy NZ/Health Navigator (Addressing inequity in primary care using the treatment of gout as an example)
• Evaluation of ‘Gout Stop’ and ‘Owning My Gout’ management programmes
• Hutt Union and Community Health Service (gout starter pack to assist new patients and standardise care)

National Health Coalition/Papakura Marae Health Clinic (high-need population, consumer focus)

Project overview: To improve the delivery of best practice therapy for gout and reduce serum uric acid (SUA) levels in Māori and Pacific patients over 20 years classified as having gout with a SUA of >0.36mmol/L.

• Drawings from Whakakotahi learning session 1 (featuring the project and others) (1.31MB, pdf)
• Presentation from Whakakotahi learning session 2  (1.4MB, pdf)
• Presentation from Whakakotahi learning session 3 (2MB, pdf)
• Commission news article ‘For our whānau, for our community - building a system of care to reduce gout’ (August 2017) 

Westbury Pharmacy and Hora Te Pai (integrated community pharmacist working as an in-practice clinical pharmacist)

Project overview: The 'hauora pai' project (Māori for 'good health') uses a multi-disciplinary approach and a locally constructed, patient-led model of care to improve Māori and Pacific patients' long-term gout management and reduce inequity of service provision. This project is supported by PHARMAC Te Pātaka Whaioranga.

• Presentation from Whakakotahi learning session 1 (596KB, pdf)
• Presentation from Whakakotahi learning session 2 (1.25MB, pdf)
• Presentation from Whakakotahi learning session 3 (439KB, pdf)
• Pharmacy Today article about the project (March 2019)

Health Literacy NZ/Health Navigator (Addressing inequity in primary care using the treatment of gout as an example)

Achieving equitable health outcomes is a major focus across Aotearoa, and yet sometimes we struggle to know what we can do within our sphere of influence to improve equity and reduce health outcome disparities. In this nine-minute video, Susan Reid from Health Literacy NZ gives a brief introduction to equity, followed by a discussion on the treatment of gout as an example of widely seen inequitable health outcomes across Aotearoa. 

Primary care multidisciplinary teams are uniquely positioned to address this inequity. Susan provides practical ideas and suggestions for general practice clinics and primary care teams, to consider and start implementing initiatives to help address inequities in the area of gout treatment.

The video is supported by a guide for practice teams, GP and nurse peer groups or PHO facilitators to use this video to stimulate discussion and action.

• Guide for clinical teams using the video 'addressing inequity in primary care (364KB, pdf)
• Susan Reid from Health Literacy NZ talks about addressing inequity in primary care

Evaluation of ‘Gout Stop’ and ‘Owning My Gout’ management programmes

In July 2020, The Commission hosted a webinar based upon the work led by Arthritis New Zealand and supported by Health Literacy NZ, the Commission and PHARMAC Te Pātaka Whaioranga.

This seminar was based on the Synergia evaluation of the ‘Gout Stop’ led by Aniva Lawrence and provided by Mahitahi Hauora PHE in the Northland DHB region, and ‘Owning My Gout’ programmes led by Diana Phone through Counties Manukau Health. The evaluation looked at equitable approaches to gout management in Aotearoa New Zealand with a focus on the key components for establishing and maintaining gout management systems in primary care.

Resources available:

• Webinar: Equitable approaches to gout management – latest research and evidence 
•  Arthritis New Zealand Synergia report (including summary of findings and ‘Implementing gout management programmes in primary care’)
• Question and answer document (71KB, docx)
• Interventions to improve uptake of urate-lowering therapy in patients with gout: a systematic review

Hutt Union and Community Health Service (gout starter pack to assist new patients and standardise care)

The Hutt Union and Community Health Service (HUCHS) have achieved a 30 percent reduction in average uric levels with 43 percent of patients achieving the target levels through a gout improvement project. HUCHS took the lead from established gout programmes ‘Own My Gout’ (Counties Manukau region) and ‘Stop Gout’ (Mahitahi Hauora primary health entity, across Northland District Health Board).

The HUCHS gout improvement project was run by a HUCHS GP and a clinical pharmacist and acts as an example of how a small team with limited resources can make a real difference for their patients through iterative cycles of reflection and adaptation as well as efforts to promote best practice in the management of gout.

This project also reports success in improving equity in Māori and Pacific communities, with 80 percent of patients involved being of Māori and/or Pacific ethnicity.

Download a copy of the project report (266KB, pdf)