Effectiveness of healthcare educational and behavioral interventions to improve gout outcomes: a systematic review and meta-analysis

Abstract

Background:We aimed to systematically review the effectiveness of healthcare behavioral and education interventions for gout patients on clinical outcomes.Methods:We searched multiple databases to identify trials or observational studies of educational or behavioral interventions in gout. Risk of bias was assessed with the Cochrane tool for randomized control trials (RCTs) and the Newcastle–Ottawa Scale for observational studies. We estimated odds ratios (ORs) for categorical and standardized mean difference (SMD) for continuous measures using a random-effects model.Results:Overall, eight (five RCTs and three observational) studies met the inclusion criteria and examined pharmacist-led interventions (n = 3), nurse-led interventions (n = 3) and primary care provider interventions (n = 2). Compared with the control intervention (usual care in most cases), a higher proportion of those in the educational/behavioral intervention arm achieved serum urate (SU) levels <6 mg/dl, 47.2% versus 23.8%, the OR was 4.86 [95% confidence interval (CI), 1.48, 15.97; 4 RCTs] with moderate quality evidence. Compared with the control intervention, a higher proportion of those in the educational/behavioral intervention arm were adherent to allopurinol, achieved at least a 2 mg/dl decrease in SU, achieved an SU < 5 mg/dl, had a reduction in the presence of tophi at 2 years, had improved quality of life as assessed with SF-36 physical component scores, had a higher knowledge about gout and higher patient satisfaction (moderate-low quality evidence).Conclusion:Educational and behavioral interventions can improve gout outcomes in the short-intermediate term. Randomized trials are needed to assess its impact on long-term gout outcomes.

Persistence with urate‐lowering therapy in Australia: A longitudinal analysis of allopurinol prescriptions

“…The findings from this study highlight the need for improvements in gout education and management in Australia. To date, a range of interventions have been examined internationally with promising results 31 . In particular, a Community Pharmacy Gout Management Service has proven successful in improving outcomes for people with gout in New Zealand 32 .…”

The Effect of Health Education on The Knowledge and Adherence of Diet for Gout Arthritis Patients

“…Adanya peningkatan pengetahuan dapat dipengaruhi oleh pemberian pendidikan kesehatan tentang penyakit asam urat. Hal Anatun Aupia / The Effect of Health Education on The Knowledge and Adherence of Diet for Gout Arthritis Patients ini membuktikan bahwa pendidikan kesehatan dapat diterima baik, bisa memahami serta meningkatkan pengetahuan responden dalam mengatasi penyakit asam urat [14].…”

“…Penderita asam urat memiliki keingintahuan tentang makanan yang aman untuk dikonsumsi, makanan yang meningkatkan asam urat mereka dan prilaku apa saja yang tepat untuk dilakukan guna mengurangi sakit yang diderita [19]. Setelah mendapatkan informasi mengenai hal-hal tersebut, penderita akan memperbaiki prilaku-prilaku yang tidak tepat dengan menjalankan diet asam urat yang benar [14].…”

Predictors of Success in Gout Treatment

“…The need to effectively manage gout is increasingly recognized as important because (1) gout is prevalent, and increasingly so, despite the proven effectiveness of urate-lowering therapies (ULT) such as allopurinol 2,3,4 ; (2) the effect on individuals, their families, and society has been significantly underappreciated 5,6 ; and (3) the documented poor adherence to ULT (< 50%) 7 has been moderately resistant to a wide range of interventions 8,9,10,11 . Further, there is increasing concern that poorly controlled gout is a harbinger of premature and serious cardiovascular and/or renal impairments 9,12 .…”