goutchoices wireframe
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Gout Choices
Gout
Gout symptoms and attack triggers
Advancing gout awareness
and treatment options
Gout
News feed pulling
medical articles that
mention gout
Administrator
ability to enter
Calendar events
Evaluate Treatments
Treatments Food/Diet Alcohol
Sponsor Banner
Opportunities
Sponsor Banner
OpportunitiesSponsor Banner
Opportunities
CONTACT DETAILS TO BE ADDED
Gout Choice Alliance.
Track Gout Symptoms
Attack/FlareResearch
Opportunities
WordPress Blog?
Gout Diary App
G
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Four Rotating Banners
Gout Awareness
Study
Link to Amazon Gout
Products (affiliate
program)
Find a Clinical Trial
Graphic Design needed
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About Gout
High level overview of gout and consequences
ending with a need for new treatments
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Treatments
Need to provide rationale for when sUA loweringtherapy should be initiated (e.g., generallygreater than 2 flares within a year and sUA>6).NEED a paragraph explaining that initiating sUA
may cause flares and the importance ofprophylactic treatment for flares
=>point out the goal of therapy is to lower sUAbelow 6 and once it is below 6 for a period of
time the chance of flare and other gout relatedimpairment is significantly reduced // ifsymptoms continue lower sUA further
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Treatments
Section on current treatments
Allopurinol
Febuxostat (Uloric/Other brand names)
ProbenecidBenzbromarone
Pegloticase (Krystexxa)
Section on treatments in development
Lesinurad
Y-700XOMA 052
Others
Need short descriptions of each treatment mechanism of action, common
dosing, and highlight limitations and safety problems. Also identify drug
company for branded products and link to patient assistance or productwebsite.
CONTACT US IF THERE IS ANOTHER PRODUCT THAT SHOULD BE ADDED OR TORECOMMEND CHANGES
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Food/Diet
Add a brief review of recommended food/diet
for patients with gout. Identify foods and
drinks that are common triggers to gout flares.
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Research Opportunities
List Clinical trials and link to external sites
Link to form where interested companies can contact
GoutChoices about providing information about theirclinical trial
Gout Evaluation Study Gout Awareness part IIll provide background and a link to
the study
Gout Comorbidity part IIIll provide background and a linkto the study
Gout Economic Burden part IIIIll provide background and alink to the study
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Alcohol
Comment about gout and alcohol (this is an
important issue for patients with gout key
search activity is alcohol and gout)
Take home message: If you want to drink, beer is probably
the most problematic and cider and red wine the least.
Once you sUA is below 6 for a period of time food or drink
choice are less likely to cause flares => bring sUA below 6
and drink what you want.
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Flares/Attacks
Add information on flares/attacks
Section on immediate flare treatment if you are
having a flare now..
Section on current flare treatments
Cochicine
NSAIDS
COX2s
Steriods
Opioids (once chronic pain sets in)Section on flare treatments in development
CANAKINUMAB
OTHERS
CONTACT US IF THERE IS ANOTHER PRODUCT THAT SHOULD BE ADDED OR TORECOMMEND CHANGES
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Track Symptoms or Evaluate
Treatments or IPhone App
Prompt to Log-in or Register
User Name: Password:
Register
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Registration
UserName
Password
Country (optional / United States should be first)
State (optional)
Zip Code (optional)
Agree to privacy policy (need to find/create
flexible privacy policy) Image Verification
Email confirmation
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Registration Pt II (after email confirmation)
Thank you for registering
Tell us about yourself Diagnosed with gout by a doctor?
Yes Date MMYYYY
No
Age Years (18 to 120)
Sex Male or Female
Number of flares in last month _____
Number of flares in last year ____
Last time serum uric acid (sUA) was measured MMYYYY or dont know. sUAlevel ________
Do you have any visible tophi? Yes
No
Dont Know
Do you wish to be contacted about potential research or educaitonalopportunities? Yes / No (if yes, enter best email address to use:_______)
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If Registered
Track Symptoms (link)
Evaluate Treatments (link)
IPhone Application(link)
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Track Symptoms
Track symptoms is a weekly assessment of you gout symptoms, attacks/flares, medication use and isdesigned to help you identify gout attack triggers. If you agree to participate youll be sent a weeklylink to assess you gout symptoms.
To participate enter you email address: ___________________
(you can opt out at any time)
(agree to consent document check box and link)
Image Verification
SUBMIT
Thank you
Email sends link to the symptom tracker questions (a new email will be sent each week at
the same time until they opt out of the program)
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Symptom Tracker Weekly
Questionnaire Pre-populate date and time, IP address and location (ONLY in database)
when they click on link they can complete the survey once every 7 daysand a database needs to be created to track data over time. Databaseshould create unique Subject ID linked to email and site user name.
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In general, would you say your health is:
O Excellent O Very Good O Good O Fair O Poor
On a scale of 0 (worst possible health) to 100 (best possible health) howwould you rate your health today?
0 to 100 (some type of visual scale would be good)
In the past 7 days did you have or are you currently experiencing a gout attack(flare)? (yes,no)
Is this a new flare? (yes,no)
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ONLY FOR PATIENTS with a FLARE
Considering PAIN from your gout flare over the last 1week when you are RESTING (for example in bed orsitting quietly) please indicate (0 to 10) the numberindicating the level of pain when it was at its WORST:
No pain (0) to Worst imaginable pain (10)
During this gout flare, did you have warmth of themost severe joint (yes,no)
During this gout flare, did you have swelling of themost severe joint? (yes,no)
During this gout flare, did you have tenderness of themost severe joint (yes,no)
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ONLY FOR PATIENTS WITH A FLARE
Did you eat or drink anything prior to the flarethat may have triggered the flare? (yes, no)
List up to 3 foods or drinks that may have causedthe flare: 1. _________
2. _________
3. _________
Where there any out of the ordinary stressfulevents which may have contributed to the flare:
If yes, please describe: (e.g., stressful week atwork) _____________________
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ONLY FOR PATIENTS with a FLAREDuring the last week, did you visit or call any of the following health care services because of your gout flare? (Iselect all that apply):
Primary Care Physician or General Practitioner
How many total number ofvisits were made to the health care provider(s)for this flare? _____. (allow 0 7)
How many times did you talk directly on the phone with the health care provider(s) for this flare? _____. (allow 0 7)
Rheumatologist or other specialist
How many total number ofvisits were made to the health care provider(s)for this flare? _____. (allow 0 7)
How many times did you talk directly on the phone with the health care provider(s) for this flare? _____. (allow 0 7)
Physician Assistant or Nurse Practitioner
How many total number ofvisits were made to the health care provider(s)for this flare? _____. (allow 0 7)
How many times did you talk directly on the phone with the health care provider(s) for this flare? _____. (allow 0 7)
Urgent Care Facility
How many total number ofvisits were made to the health care provider(s)for this flare? _____. (allow 0 7)
How many times did you talk directly on the phone with the health care provider(s) for this flare? _____. (allow 0 7)
Emergency Room
How many total number ofvisits were made to the health care provider(s)for this flare? _____. (allow 0 7)How many times did you talk directly on the phone with the health care provider(s) for this flare? _____. (allow 0 7)
On how many days during the last week did your symptoms cause you to miss school or work or leave you unable to do your normal daily
activities? (allow 0-7 )
On how many days during the last week did you feel so impaired by your symptoms, that even though you went to school or work, your
productivity was reduced? (allow 0-7)
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All subjects in the Tracker Program
Please indicate which gout medications you arecurrently takingO Allourinol
O Febuxostat
O Probenecid
O Benzbromarone
O Pegloticase
O Colchochine (Colcrys)
O Pain medicationsO Gout medication in a clinical trial
O Other (Please identify:______________)
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All subjects in the Tracker Program
For each medications that you indicated you are taking please tell us the following:
What dose of _allopurinol_ are you currently taking? _0 to 1000___mg/day
- When did you start taking _allopurinol_? MMYYYY (This question is ONLY asked once per drug andnot every week)
- How much does it cost you out-of-pocket (e.g., $20 co-pay) to obtain _allopurinol_? ________($,Euro, Etc)
(this question should only be asked one time per year e.g., if they answer this question in2012 it should only come up again in 2013)
Repeat (above) for each medication they checked on the previous page / exclude the Goutmedication in a clinical trial and Other category
During the last week did you miss taking your gout medication?
No, I took my gout medication as prescribed everyday.
Yes, I missed 1 day of my gout medication.
Yes, I missed 2-3 days of gout medication.
Yes, I missed 4 days or more of gout medication.
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Common Lab values
We want to help keep track of your lab values over time. sUA is related to
gout attacks/flares and other health problems. Achieving sUA below 6 may
reduce and potentially eliminate flares. (show past values & dates in table
they will be asked this every week and data is not likely to change much
but I want to track changes over time)
sUA _value Date previous value/date
LDL _value Date previous value/date
HA1c _value Date previous value/date
_Other User Defined_1 Date previous value/date
_Other User Defined_2 Date previous value/date
_Other User Defined_3 Date previous value/date
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TRACKER REPORT
Personalized Record for Participants in GoutTracking Program (this should be part of the users profile(or a link available on the user profile page) and they can choice tokeep private or share with other members)
User name:
Tracking Since: Date
Number of completed assessments: _n_
Currently taking the following gout medications: Allopurinol 300mg per day and
Flares: _n_ flares in the last _n_ weeks Possible flare triggers include: _list flare trigger patient identified_
Most recent sUA value: _________
Generally doctors aim to treat sUA unitl it is less than 6. Taking sUA lowering drugs every day (oras instructed by your physician) is very important to lower sUA.
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If Registered
Track Symptoms (link)
Evaluate Treatments (link)
iPhone App (link)
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Gout Treatment Evaluations
Please indicate which gout treatments youwould like to evaluate:
O Allourinol
O FebuxostatO Probenecid
O Benzbromarone
O Pegloticase
O Colchochine (Colcrys)
O Other (Please identify:______________)
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For Each Treatment Identified
Are you currently taking allopurinol? Yes/no
How long have you been taking or did you take_allopurinol_? Years and Months
- What is the highest dose of the _allopurinol_ used?
_____mg per day
How satisfied are you with _allopurinols_ ability to reducegout flares?
How satisfied are you with _allopurinols_ ability to reducesUA?
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For Each Treatment Identified
How bothersome are the side effects of
_allopurinol_?
1 Extremely Bothersome
2 Very Bothersome
3 Somewhat Bothersome
4 A Little Bothersome5 Not at All Bothersome
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For Each Treatment Identified
How convenient or inconvenient is it to take the_allopurinol_ as instructed?
1 Extremely Inconvenient2 Very Inconvenient
3 Inconvenient
4 Somewhat Convenient
5 Convenient6 Very Convenient
7 Extremely Convenient
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For Each Treatment Identified
Taking all things into account, how satisfied ordissatisfied are you with_allopurinol_?
1 Extremely Dissatisfied2 Very Dissatisfied
3 Dissatisfied
4 Somewhat Satisfied
5 Satisfied6 Very Satisfied
7 Extremely Satisfied
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TREATMENT EVALUATIONS REPORT
Personalized Record for Participants (this should be partof the users profile (or a link available on the user profile page) and they
can choice to keep private or share with other members)
User name:
For each Drug Evaluated the following information should be summarized:
Drug name_allopurinol_
Time taking drug _Years_Months_
Highest Dose
Efficacy for flare reduction: 0 (lowest) to 10 (best) or NA
Efficacy for sUA reduction: 0 (lowest) to 10 (best) or NA
Side effects: 1 to 5
Convenience: 1 to 7
OVERALL SATISFACTION: 1 to 7
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If Registered
Track Symptoms (link)
Evaluate Treatments (link)
IPhone App
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IPhone App
The Iphone App is a mirror of the tracker
application on the web site and the data
entered on the web site should sync to the
Iphone app.
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Additional Pages Needed
About Us
Privacy Policy and Consent (see patientslikeme.com)
Mailing Address and Phone Number
For Policy Makers (need to draft)
Disclaimer
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