PDF(Pubmed)
Abstract：
BACKGROUND: Gout management remains suboptimal despite safe and effective urate-lowering therapy. Self-monitoring of urate may improve gout management, however, the acceptability of urate self-monitoring by people with gout is unknown. The aim of this study was to explore the experiences of urate self-monitoring in people with gout.
METHODS: Semistructured interviews were conducted with people taking urate-lowering therapy (N = 30) in a 12-month trial of urate self-monitoring in rural and urban Australia. Interviews covered the experience of monitoring and its effect on gout self-management. Deidentified transcripts were analysed thematically.
RESULTS: Participants valued the ability to self-monitor and gain more understanding of urate control compared with the annual monitoring ordered by their doctors. Participants indicated that self-monitoring at home was easy, convenient and informed gout self-management behaviours such as dietary modifications, hydration, exercise and medication routines. Many participants self-monitored to understand urate concentration changes in response to feeling a gout flare was imminent or whether their behaviours, for example, alcohol intake, increased the risk of a gout flare. Urate concentrations were shared with doctors mainly when they were above target to seek management support, and this led to allopurinol dose increases in some cases.
CONCLUSIONS: Urate self-monitoring was viewed by people with gout as convenient and useful for independent management of gout. They believed self-monitoring achieved better gout control with a less restricted lifestyle. Urate data was shared with doctors at the patient\'s discretion and helped inform clinical decisions, such as allopurinol dose changes. Further research on implementing urate self-monitoring in routine care would enable an evaluation of its impact on medication adherence and clinical outcomes, as well as inform gout management guidelines.
UNASSIGNED: One person with gout, who was not a participant, was involved in the study design by providing feedback and pilot testing the semistructured interview guide. In response to their feedback, subsequent modifications to the interview guide were made to improve the understandability of the questions from a patient perspective. No additional questions were suggested.
METHODS: Semistructured interviews were conducted with people taking urate-lowering therapy (N = 30) in a 12-month trial of urate self-monitoring in rural and urban Australia. Interviews covered the experience of monitoring and its effect on gout self-management. Deidentified transcripts were analysed thematically.
RESULTS: Participants valued the ability to self-monitor and gain more understanding of urate control compared with the annual monitoring ordered by their doctors. Participants indicated that self-monitoring at home was easy, convenient and informed gout self-management behaviours such as dietary modifications, hydration, exercise and medication routines. Many participants self-monitored to understand urate concentration changes in response to feeling a gout flare was imminent or whether their behaviours, for example, alcohol intake, increased the risk of a gout flare. Urate concentrations were shared with doctors mainly when they were above target to seek management support, and this led to allopurinol dose increases in some cases.
CONCLUSIONS: Urate self-monitoring was viewed by people with gout as convenient and useful for independent management of gout. They believed self-monitoring achieved better gout control with a less restricted lifestyle. Urate data was shared with doctors at the patient\'s discretion and helped inform clinical decisions, such as allopurinol dose changes. Further research on implementing urate self-monitoring in routine care would enable an evaluation of its impact on medication adherence and clinical outcomes, as well as inform gout management guidelines.
UNASSIGNED: One person with gout, who was not a participant, was involved in the study design by providing feedback and pilot testing the semistructured interview guide. In response to their feedback, subsequent modifications to the interview guide were made to improve the understandability of the questions from a patient perspective. No additional questions were suggested.
摘要：
背景：尽管有安全有效的降尿酸治疗，但痛风管理仍不理想。尿酸盐的自我监测可以改善痛风管理，然而,痛风患者对尿酸盐自我监测的可接受性尚不清楚。这项研究的目的是探索痛风患者尿酸盐自我监测的经验。
方法：在澳大利亚农村和城市的一项为期12个月的尿酸自我监测试验中，对服用降尿酸治疗（N=30）的患者进行了半结构化访谈。访谈涵盖了监测的经验及其对痛风自我管理的影响。主题分析了鉴定的转录本。
结果：与医生下令的年度监测相比，参与者重视自我监测的能力，并获得了对尿酸盐控制的更多了解。参与者表示，在家中进行自我监控很容易，方便和知情的痛风自我管理行为，如饮食调整，水合作用,锻炼和药物常规。许多参与者自我监测，以了解尿酸浓度的变化，以响应痛风发作迫在眉睫的感觉或他们的行为，例如,酒精摄入量,增加了痛风发作的风险。尿酸盐浓度主要在高于目标时与医生分享，以寻求管理支持，在某些情况下，这导致别嘌呤醇剂量增加。
结论：痛风患者认为Urate自我监测对于痛风的独立管理是方便和有用的。他们认为自我监测可以更好地控制痛风，减少生活方式的限制。根据患者的判断，与医生共享Urate数据，并帮助临床决策。如别嘌呤醇剂量变化。关于在常规护理中实施尿酸盐自我监测的进一步研究将能够评估其对药物依从性和临床结果的影响，以及告知痛风管理指南。
■一个痛风患者,谁不是参与者，通过提供反馈和试点测试半结构化访谈指南参与了研究设计。为了回应他们的反馈,随后对访谈指南进行了修改,以提高患者对问题的理解能力.没有提出其他问题。
方法：在澳大利亚农村和城市的一项为期12个月的尿酸自我监测试验中，对服用降尿酸治疗（N=30）的患者进行了半结构化访谈。访谈涵盖了监测的经验及其对痛风自我管理的影响。主题分析了鉴定的转录本。
结果：与医生下令的年度监测相比，参与者重视自我监测的能力，并获得了对尿酸盐控制的更多了解。参与者表示，在家中进行自我监控很容易，方便和知情的痛风自我管理行为，如饮食调整，水合作用,锻炼和药物常规。许多参与者自我监测，以了解尿酸浓度的变化，以响应痛风发作迫在眉睫的感觉或他们的行为，例如,酒精摄入量,增加了痛风发作的风险。尿酸盐浓度主要在高于目标时与医生分享，以寻求管理支持，在某些情况下，这导致别嘌呤醇剂量增加。
结论：痛风患者认为Urate自我监测对于痛风的独立管理是方便和有用的。他们认为自我监测可以更好地控制痛风，减少生活方式的限制。根据患者的判断，与医生共享Urate数据，并帮助临床决策。如别嘌呤醇剂量变化。关于在常规护理中实施尿酸盐自我监测的进一步研究将能够评估其对药物依从性和临床结果的影响，以及告知痛风管理指南。
■一个痛风患者,谁不是参与者，通过提供反馈和试点测试半结构化访谈指南参与了研究设计。为了回应他们的反馈,随后对访谈指南进行了修改,以提高患者对问题的理解能力.没有提出其他问题。
