Factors Influencing Self-Management Behaviors Among Patients with Gout: A Scoping Review

Abstract

Objective: This study aimed to explore the factors influencing self-management behavior in gout patients to provide a basis for future intervention research. Methods: According to the scope review method framework, the research questions were established. The Chinese and English literatures (EMBASE, PubMed, CINAHL, Web of Science, China Biology Medicine Disc, China National Knowledge Infrastructure, Wan Fang Database.) published up to March 2023 were searched and screened to identify relevant studies. The PRISMA-ScR checklist was adopted in this study. Results: A total of 52 articles were included. The influencing factors of gout patients' self-management behavior included the social demographic data such as gender, age, education level, economic situation, and disease awareness of gout patients, disease-related factors such as course of disease and complications, psychological factors such as self-efficacy of patients, and the level of social support all have a certain impact on the self-management behavior of gout patients. Conclusion: Based on previous literature, we reviewed various influencing factors of self-management behavior of gout patients to provide theoretical basis for precise nursing intervention for patients, and lay the foundation for improving self-management behavior of gout patients and reducing gout recurrence.

Keywords

Gout / Arthritis / Self-management behavior / Influencing factors / Scoping review / Adherence

References

[1] Arksey H. O., & Malley L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8, 19-32.

[2] Bandura A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. https://doi.org/10.1037//0033-295x.84.2.191

[3] Briesacher B. A., Andrade S. E., Fouayzi H., & Chan K. A. (2008). Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy, 28(4), 437-443. https://doi.org/10.1592/phco.28.4.437

[4] Chua X. H. J., Lim S., Lim F. P., Lim Y. N. A., He H. G., & Teng G. G. (2018). Factors influencing medication adherence in patients with gout: A descriptive correlational study. Journal of Clinical Nursing, 27(1-2), e213-e222. https://doi.org/10.1111/jocn.13918

[5] Chung M. K., Kim S. S., Cheon Y. H., Hong S. J., Choi H. J., Seo M. R., Hwang J., Ahn J. K., Lee S. H., Min H. K., Cha H. S., Lee S. S., Lee J., Moon K. W., Lee C. K., Kim H. O., Suh Y. S., Shim S. C., Kang S. W., … & Lee J. (2021). Patient perspectives and preferences regarding gout and gout management: Impact on adherence. Journal of Korean Medical Science, 36(32), e208. https://doi.org/10.3346/jkms.2021.36.e208

[6] Coburn B. W., Bendlin K. A., Sayles H., Meza J., Russell C. L., & Mikuls T. R. (2017). Allopurinol medication adherence as a mediator of optimal outcomes in gout management. Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases, 23(6), 317-323. https://doi.org/10.1097/RHU.0000000000000561

[7] Coleshill M. J., Day R. O., Tam K., Kouhkamari M., Caillet V., Aung E., Kannangara D. R. W., Cronin P., Rodgers A., & Stocker S. L. (2022). Persistence with urate-lowering therapy in Australia: A longitudinal analysis of allopurinol prescriptions. British Journal of Clinical Pharmacology, 88(11), 4894-4901. https://doi.org/10.1111/bcp.15435

[8] Dai X., He B, & Xiang Z. (2017). Analysis of factors influencing the compliance of uric acid-lowering therapy in gout patients. South China Journal of National Defense Med, 31(7), 442-444. https://doi.org/10.13730/j.issn.1009-2595.2017.07.004

[9] Dalbeth N., Gosling A. L., Gaffo A., & Abhishek A. (2021). Gout. Lancet (London, England), 397(10287), 1843-1855. https://doi.org/10.1016/S0140-6736(21)00569-9

[10] Dalbeth N., House M. E., Horne A., Petrie K. J., McQueen F. M., & Taylor W. J. (2012). Prescription and dosing of urate-lowering therapy, rather than patient behaviours, are the key modifiable factors associated with targeting serum urate in gout. BMC Musculoskeletal Disorders, 13, 174. https://doi.org/10.1186/1471-2474-13-174

[11] Dehlin M., Scheepers L., Landgren A. J., Josefsson L., Svensson K., & Jacobsson L. (2022). Lifestyle factors and comorbidities in gout patients compared to the general population in Western Sweden: Results from a questionnaire study. Scandinavian Journal of Rheumatology, 51(5), 390-393. https://doi.org/10.1080/03009742.2022.2035952

[12] Feng J. (2018). Treament compliance and hyperuricemia in gout patients in Conghua, Guangdong Study of related diseases [Master’s degree, Southern Medical University]. https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C475KOm_zrgu4lQARvep2SAkWfZcByc-RON98J6vxPv10eoN_V6Da0-LajiwpKEGU0NxVE7nH9BzyuzZYInajhGL&uniplatform=NZKPT

[13] Feng J., & Yang M. (2017). The analysis of factors related to adherence to the diagnosis and treatment of gout patients after discharge. ChongQingYiXue, 46(5), 604-606.

[14] Fu Q. (2020). Status and influencing factors of compliance with uric acid-lowering therapy in gout patients. Health Must Read, 5, 226.

[15] Fu T., Cao H., Yin R., Zhang L., Zhang Q., Li L., Feng X., & Gu Z. (2018). Depression and anxiety correlate with disease-related characteristics and quality of life in Chinese patients with gout: A case-control study. Psychology, Health & Medicine, 23(4), 400-410. https://doi.org/10.1080/13548506.2017.1378819

[16] Fu X. (2005). Investigation on the compliance of gout patients with diet therapy. Sichuan Med, 26(4), 474-475. https://doi.org/10.3969/j.issn.1004-0501.2005.04.066

[17] Gao H. (2015). Compliance in intercriticalgout patients and its related factors. Chinese Journal of Medicine, 27, 2186-2189. https://doi.org/10.3760%2520/%2520cma.%2520J.i%2520SSN.%25200376-2491.2015.27.017

[18] Hu S., Terkeltaub R., Sun M., Ji X., Li Z., Ran Z., Li Y., Zhang H., Sun W., Li C., & Lu J. (2022). Palpable tophi and more comorbidities associated with adherence to urate-lowering medical therapy in a Chinese gout cohort. Joint Bone Spine, 89(6), 105435. https://doi.org/10.1016/j.jbspin.2022.105435

[19] Janssen C. A., Oude Voshaar M. a. H., Vonkeman H. E., Krol M., & van de Laar M. a. F. J. (2018). A retrospective analysis of medication prescription records for determining the levels of compliance and persistence to urate-lowering therapy for the treatment of gout and hyperuricemia in The Netherlands. Clinical Rheumatology, 37(8), 2291-2296. https://doi.org/10.1007/s10067-018-4127-x

[20] Jiang H. (2021). Investigation and analysis of influencing factors on medication compliance of gout patients with uric acid-lowering therapy[Master's degree]. Chengdu Medical College .

[21] Kim A., Kim Y., Kim G. T., Ahn E., So M. W., & Lee S. G. (2020). Comparison of persistence rates between allopurinol and febuxostat as first-line urate-lowering therapy in patients with gout: An 8-year retrospective cohort study. Clinical Rheumatology, 39(12), 3769-3776. https://doi.org/10.1007/s10067-020-05161-w

[22] Lee S., & So M. W. (2016). Adherence with urate-lowering therapies among male patients with gout in a routine clinical setting. Modern Rheumatology, 26(6), 950-955. https://doi.org/10.3109/14397595.2016.1170914

[23] Lee S., So M. W., & Ahn E. (2019). Long-term adherence and persistence with febuxostat among male patients with gout in a routine clinical setting. Modern Rheumatology, 29(4), 662-668. https://doi.org/10.1080/14397595.2018.1483293

[24] Li L., & Li X. (2023). Status and risk factors of self-management behavior in patients with gout. General Nursing, 21(5), 687-689. https://doi.org/10.12104/j.issn.1674-4748.2023.05.028

[25] Li Y., Liu T., Yao X., Miao X., Li Y., Li X., & Yan J. (2019). Medication adherence and its influencing factors among male gout patients at home. Journal of Nursing Science, 34(17), 79-82+93. https://doi.org/10.3870/%2520j.iscn.1001-4152.2019.17.079

[26] Lin S., Zhang H., & Ma A. (2018). Association of gout and depression: A systematic review and meta-analysis. International Journal of Geriatric Psychiatry, 33(3), 441-448. https://doi.org/10.1002/gps.4789

[27] Liu H. (2015). Gout patients compliance and the relationship between self-efficacy and coping strategies. International Journal of Nursing, 34(2), Article 02. https://doi.org/10.3760/cma.j.issn.1673-4351.2015.02.041

[28] Liu X. (2010). Investigation and analysis of diet control compliance in patients with gouty nephropathy. Chin Contemporary Med, 17(20), 150-151. https://doi.org/10.3969/j.issn.1674-4721.2010.20.092

[29] Lorig K. R., & Holman H. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 26(1), 1-7. https://doi.org/10.1207/S15324796ABM2601_01

[30] Luo H., Shu Y., Liang W., & Chen Y. (2019). Investigation on the compliance of gout patients with hyperuricemia and its influencing factors. Jilin Medicine, 40(6), 1379-1380. https://doi.org/10.3969/j.issn.1004-0412.2019.06.103

[31] Ma Z. (2018). Investigation and analysis treatment compliance in patients with gout [Master’s degree, Hubei Minzu University]. https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C475KOm_zrgu4lQARvep2SAkWfZcByc-RON98J6vxPv10ZMwhjYppovb84wcmk_gsD-povtEb9OYohN5rVslEYx27&uniplatform=NZKPT

[32] Mantarro S., Capogrosso-Sansone A., Tuccori M., Blandizzi C., Montagnani S., Convertino I., Antonioli L., Fornai M., Cricelli I., Pecchioli S., Cricelli C., & Lapi F. (2015). Allopurinol adherence among patients with gout: An Italian general practice database study. International Journal of Clinical Practice, 69(7), 757-765. https://doi.org/10.1111/ijcp.12604

[33] McGowan B., Bennett K., Silke C., & Whelan B. (2016). Adherence and persistence to urate-lowering therapies in the Irish setting. Clinical Rheumatology, 35(3), 715-721. https://doi.org/10.1007/s10067-014-2823-8

[34] Meng J. (2018). Treatment compliance and uric acid control rate in patients with primary gout. Journal of the Chinese General Practitioner Journal, 4, 281-285. https://doi.org/10.3760%2520/%2520cma.%2520J.i%2520SSN.%25201671-7368.2018.04.009.

[35] Pascart T., Latourte A., Flipo R. M., Chalès G., Coblentz-Baumann L., Cohen-Solal A., Ea H. K., Grichy J., Letavernier E., Lioté F., Ottaviani S., Sigwalt P., Vandecandelaere G., Richette P., & Bardin T. (2020). 2020 recommendations from the French Society of Rheumatology for the management of gout: Urate-lowering therapy. Joint Bone Spine, 87(5), 395-404. https://doi.org/10.1016/j.jbspin.2020.05.002

[36] Perez-Ruiz F., Perez-Herrero N., Richette P., & Stack A. G. (2020). High rate of adherence to urate-lowering treatment in patients with gout: Who's to Blame? Rheumatology and Therapy, 7(4), 1011-1019. https://doi.org/10.1007/s40744-020-00249-w

[37] Ye Q., Du W. X., & Tao H. (2021). Analysis of treatment compliance and related factors of gout patients in intermittent period. Journal of Hubei University of Medicine, 40(1), 35-40. https://doi.org/10.13819/j.issn.2096-708X.2021.01.008

[38] Rashid N., Coburn B. W., Wu Y. L., Cheetham T. C., Curtis J. R., Saag K. G., & Mikuls T. R. (2015). Modifiable factors associated with allopurinol adherence and outcomes among patients with gout in an integrated healthcare system. The Journal of Rheumatology, 42(3), 504-512. https://doi.org/10.3899/jrheum.140588

[39] Reach G., Chenuc G., Maigret P., Elias-Billon I., Martinez L., & Flipo R. M. (2019a). Implication of character traits in adherence to treatment in people with gout: A reason for considering nonadherence as a syndrome. Patient Preference and Adherence, 13, 1913-1926. https://doi.org/10.2147/PPA.S227329

[40] Reach G., Chenuc G., Maigret P., Elias-Billon I., Martinez L., & Flipo R. M. (2019b). Implication of character traits in adherence to treatment in people with gout: A reason for considering nonadherence as a syndrome. Patient Preference and Adherence, 13, 1913-1926. https://doi.org/10.2147/PPA.S227329

[41] Riedel A. A., Nelson M., Joseph-Ridge N., Wallace K., MacDonald P., & Becker M. (2004). Compliance with allopurinol therapy among managed care enrollees with gout: A retrospective analysis of administrative claims. The Journal of Rheumatology, 31(8), 1575-1581.

[42] Scheepers L. E. J. M., Burden A. M., Arts I. C. W., Spaetgens B., Souverein P., de Vries F., & Boonen A. (2018). Medication adherence among gout patients initiated allopurinol: A retrospective cohort study in the Clinical Practice Research Datalink (CPRD). Rheumatology (Oxford, England), 57(9), 1641-1650. https://doi.org/10.1093/rheumatology/key155

[43] Shao T., Liu T., Luo P., Liu J., & Che F. (2021). Analysis on the correlation between self-management capability and ehealth literacy among male patients with gout. Health Education and Health Promotion, 16(4), 349-354. https://doi.org/10.16117/j.cnki.31-1974/r.202104349

[44] Sheng F., Fang W., Zhang B., Sha Y., & Zeng X. (2017). Adherence to gout management recommendations of Chinese patients. Medicine, 96(45), e8532. https://doi.org/10.1097/MD.0000000000008532

[45] Silva L., Miguel E. D., Peiteado D., Villalba A., Mola M., Pinto J., & Ventura F. S. (2010). Compliance in gout patients. Acta Reumatologica Portuguesa, 35(5), 466-474.

[46] Singh J. A. (2014). Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: A qualitative study. Arthritis Research & Therapy, 16(2), R82. https://doi.org/10.1186/ar4524

[47] Singh J. A., Richman J., Yang S., Bridges S. L., & Saag K. (2020). Allopurinol adherence and its predictors in gout: A national cohort study in US veterans. The Lancet. Rheumatology, 2(5), e281-e291. https://doi.org/10.1016/S2665-9913(20)30029-1

[48] Sun Z. (2005). A survey of noncompliance behaviors of gout patients and its countermeasures. Chinese Nursing Research, 19(27), 2452-2453. https://doi.org/10.3969/j.issn.1009-6493.2005.27.005

[49] Tan C., Teng G. G., Chong K. J., Cheung P. P., Lim A., Wee H. L., & Santosa A. (2016). Utility of the Morisky Medication Adherence Scale in gout: A prospective study. Patient Preference and Adherence, 10, 2449-2457. https://doi.org/10.2147/PPA.S119719

[50] Tricco A. C., Lillie E., Zarin W., O'Brien K. K., Colquhoun H., Levac D., Moher D., Peters M. D. J., Horsley T., Weeks L., Hempel S., Akl E. A., Chang C., McGowan J., Stewart L., Hartling L., Aldcroft A., Wilson M. G., Garritty C., … & Straus S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467-473. https://doi.org/10.7326/M18-0850

[51] Wang Y. (2021). To study the time-varying characteristics of treatment compliance in patients with gout based on ecological moment assessment [Master’s degree, Shihezi University]. https://doi.org/10.27332/d.cnki.gshzu.2021.000599

[52] Wei F., Wang H., LIiu S., Song Y., & Chen H. (2022). Medication adherence to urate-lowering therapy and associated factors among gout patients. Journal of Preventive Medicine Information, 38(11), 1472-1479

[53] Wen Y. (2021). Analysis of compliance and influencing factors of uric acid-lowering therapy in elderly patients with gout. Chin J Geriatric Med, 19(1), 81-83. https://doi.org/10.3969/j.issn.1672-2671.2021.01.027

[54] Wu H., Zhang Y., & Lv R. (2007). Investigation of family function and self-management of gout patients. Chin J Clin Med, 8(3), 25-26. https://doi.org/10.3969/j.issn.1009-8194.2007.03.011.

[55] Xiao G. (2021). Investigation and analysis of diet control compliance in patients with gouty nephropathy. Pharmacy Weekly, 13, 73.

[56] Yang Y. (2020). Analysis of clinical characteristics and treatment compliance of elderly patients with onset gout in northeast Sichuan Province of China [Master’s degree, North sichuan medical college]. https://doi.org/10.27755/d.cnki.gcbyx.2020.000214

[57] Yao X., Liu T., Li Y., Miao X., Li Y., Li X, Zhang Y, & Zhao J. (2020). Development and psychometric testing of a Gout Patient Self-management Assessment Scale. Chiniese Journal of Nursing, 55(2), 261-265.

[58] Yi F., Xie X., He K., Yang J., Huang G., & Chen Y. (2019). Analysis on the level of self-efficacy of inpatients with gout and its influencing factors. Journal of Qilu Nursing, 25(3), 23-26.

[59] Yin R. (2017). A survey of treament adherence to urate-lowering therapy in Chinese gout patients and its influencing factors [Master’s degree, Nantong University]. https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C475KOm_zrgu4lQARvep2SAkueNJRSNVX-zc5TVHKmDNkppP6G22nH1uNflXBzFt644FQEkAa_uh7yjH3g9xI23v&uniplatform=NZKPT

[60] Yin R., Cao H., Fu T., Zhang Q., & Zhang L. (2017). The rate of adherence to urate-lowering therapy and associated factors in Chinese gout patients: A cross-sectional study. Rheumatology International, 37(7), 1187-1194. https://doi.org/10.1007/s00296-017-3746-x

[61] Ym R. (2022). Moving the needle in gout management: The role of culture, diet, genetics, and personalized patient care practices. Nutrients, 14(17). https://doi.org/10.3390/nu14173590

[62] Zandman-Goddard G., Amital H., Shamrayevsky N., Raz R., Shalev V., & Chodick G. (2013). Rates of adherence and persistence with allopurinol therapy among gout patients in Israel. Rheumatology (Oxford, England), 52(6), 1126-1131. https://doi.org/10.1093/rheumatology/kes431

[63] Zhang F. (2017). The current status and influential factors of self-management in gout patients [Master’s degree, Qingdao University]. https://kns.cnki.net/kcms2/article/abstract?v=3uoqIhG8C475KOm_zrgu4lQARvep2SAkueNJRSNVX-zc5TVHKmDNkldd-ptT62qNoWtCjMnuJFqbfsNPPxv0DzUkwvLShHIg&uniplatform=NZKPT

[64] Zhang X. (2021). A case-control study on the influencing factors of febuxostat treatment compliance in patients with gout. Chin J Prescription Med, 19(11), 67-68. https://doi.org/10.3969/j.issn.1671-945X.2021.11.030

[65] Zhao Q. (2021). Analysis of the status quo and influencing factors of self-management ability in young and middle-aged patients with gout. Chinese Journal of Modern Nursing, 27(23), 3134-3138. https://doi.org/10.3760%2520/%2520cma.%2520J.c.%2520n115682-20210421-01737

[66] Zhong X., Weng Q., Pu L., Hu Q., Zhang Y., Yang F., & Zhao Z. (2020). A survey of family function and self-management in patients with gout. Journal of Gannan Medical College, 40(8), 799-801.