Current Issues in Nurse-Led Management of Gout: A Narrative Review
DOI:
https://doi.org/10.55677/IJCSMR/V4I8-02/2024Keywords:
Gout management, nurse-led management, telemedicine, barriers, urate-lowering therapy.Abstract
Background: Gout is an inflammatory arthritis caused by elevated serum urate levels due to genetic predisposition, diet, or medical comorbidities. It affects more than 2% of the world's population, and its prevalence and incidence are anticipated to continue increasing due to the aging world. Despite this trend, its treatment remains suboptimal. Nurse-led management is more effective than traditional GP-led care. This narrative review aims to identify current issues in nurse-led management of gout and provide recommendations for future improvements.
Methods: Relevant studies were searched on the Web of Science, PubMed, ScienceDirect, and Google Scholar. Current issues in nurse-led management of gout were then thematically organized.
Results: There is high-quality evidence on the role of nurses in gout management, including patient education, individualized lifestyle/diet advice, and ULT administration. However, nurses continue to experience time constraints. Also, a few studies, though of low quality, suggested that nurses have sufficient knowledge of the clinical manifestations of gout but a limited understanding of gout management. The role of telemedicine was also revealed in two studies, but the studies were of low quality and did not reveal its effectiveness.
Conclusion: Nurse-led interventions for gout management are effective but face significant challenges like time constraints and lack of knowledge. Nurses working in rheumatology departments should be trained in effective gout management. Future research should investigate the role and effectiveness of telemedicine in nurse-led gout management.
References
Bernal, J.-A., García-Campos, J., Marco-LLedó, J., & Andrés, M. (2021). Gouty involvement of foot and ankle: Beyond flares. Reumatología Clínica (English Edition), 17(2), 106–112.
https://doi.org/10.1016/j.reumae.2019.12.004
Calvo-Aranda, E., Sánchez-Aranda, F. M., Cebrián Méndez, L., Matías De La Mano, M. D. L. Á., Lojo Oliveira, L., & Navío Marco, M. T. (2022). Perceived quality in patients with gout treated in a rheumatology clinic with a clinical nurse specialist. Reumatología Clínica (English Edition), 18(10), 608–613. https://doi.org/10.1016/j.reumae.2021.07.001
Dehlin, M., Jacobsson, L., & Roddy, E. (2020). Global epidemiology of gout: Prevalence, incidence, treatment patterns and risk factors. Nature Reviews Rheumatology, 16(7), 380–390.
https://doi.org/10.1038/s41584-020-0441-1
Deprouw, C., Guignot, M., Bougeois-Sarran, C., Bougeois-Sarran, C., Coblentz-Baumann, L., & Ea, H.-K. (2019). Partners and nurses’ knowledge and representations of gout: A qualitative study. Joint Bone Spine, 86(6), 769–776. https://doi.org/10.1016/j.jbspin.2019.04.010
Doherty, M., Jenkins, W., Richardson, H., Sarmanova, A., Abhishek, A., Ashton, D., Barclay, C., Doherty, S., Duley, L., Hatton, R., Rees, F., Stevenson, M., & Zhang, W. (2018). Efficacy and cost-effectiveness of nurse-led care involving education and engagement of patients and a treat-to-target urate-lowering strategy versus usual care for gout: A randomised controlled trial. The Lancet, 392(10156), 1403–1412. https://doi.org/10.1016/S0140-6736(18)32158-5
Fenando, A., Rednam, M., Gujarathi, R., & Widrich, J. (2024). Gout. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK546606/
Fisher, M. C., Rai, S. K., Lu, N., Zhang, Y., & Choi, H. K. (2017). The unclosing premature mortality gap in gout: A general population-based study. Annals of the Rheumatic Diseases, 76(7), 1289–1294. https://doi.org/10.1136/annrheumdis-2016-210588
Fuller, A., Jenkins, W., Doherty, M., & Abhishek, A. (2019). Nurse-led care is preferred over GP-led care of gout and improves gout outcomes: Results of Nottingham Gout Treatment Trial follow-up study. Rheumatology, kez333. https://doi.org/10.1093/rheumatology/kez333
He, Q., Mok, T.-N., Sin, T.-H., Yin, J., Li, S., Yin, Y., Ming, W.-K., & Feng, B. (2023). Global, regional, and national prevalence of gout from 1990 to 2019: Age-period-cohort analysis with future burden prediction. JMIR Public Health and Surveillance, 9, e45943. https://doi.org/10.2196/45943
Kuo, C.-F., & Luo, S.-F. (2017). Risk of premature death in gout unchanged for years. Nature Reviews Rheumatology, 13(4), 200–201.
https://doi.org/10.1038/nrrheum.2017.27
Latif, Z. P., Nakafero, G., Jenkins, W., Doherty, M., & Abhishek, A. (2019). Implication of nurse intervention on engagement with urate-lowering drugs: A qualitative study of participants in a RCT of nurse led care. Joint Bone Spine, 86(3), 357–362. https://doi.org/10.1016/j.jbspin.2018.10.008
Liu, J., Lu, N., Shen, S., & Zhang, W. (2023). Effect of comprehensive nursing intervention on quality of life and treatment outcomes in elderly patients with Gout and Hyperuricemia complicated with hypertension. Pakistan Journal of Medical Sciences, 40(3). https://doi.org/10.12669/pjms.40.3.7535
McLachlan, A., Kerr, A., Lee, M., & Dalbeth, N. (2011). Nurse-led cardiovascular disease risk management intervention for patients with gout. European Journal of Cardiovascular Nursing, 10(2), 94–100. https://doi.org/10.1016/j.ejcnurse.2010.05.001
Mirmiran, R., Bush, T., Cerra, M. M., Grambart, S., Kauschinger, E., Younger, M., & Zychowicz, M. (2018). Joint clinical consensus statement of the American College of Foot and Ankle Surgeons® and the American Association of Nurse PractitionersTM: Etiology, diagnosis, and treatment consensus for gouty arthritis of the foot and ankle. The Journal for Nurse Practitioners, 14(10), 765-769.e13.
https://doi.org/10.1016/j.nurpra.2018.09.004
Phang, K. F., Santosa, A., Low, B. P. L., Tan, P. S. H., Khong, Z. W., Lim, A. Y. N., Teng, G. G., & Tay, S. H. (2020). A nurse‐led, rheumatologist‐assisted telemedicine intervention for dose escalation of urate‐lowering therapy in gout. International Journal of Rheumatic Diseases, 23(9), 1136–1144.
https://doi.org/10.1111/1756-185X.13855
Rasmussen, C., Larsen, J. W., Christensen, H. M., Larsen, M. B., Thomsen, A. M., Leishmann, T., Kragh, J., & Nielsen, G. L. (2024). Optimising gout treatment: Insights from a nurse-led cohort study. RMD Open, 10(2), e004179. https://doi.org/10.1136/rmdopen-2024-004179
Rees, F., Jenkins, W., & Doherty, M. (2013). Patients with gout adhere to curative treatment if informed appropriately: Proof-of-concept observational study. Annals of the Rheumatic Diseases, 72(6), 826–830. https://doi.org/10.1136/annrheumdis-2012-201676
Sedelius, H., Tistad, M., Bergsten, U., Dehlin, M., Iggman, D., Wallin, L., & Svärd, A. (2022). Professionals’ perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: A qualitative study in primary healthcare. BMC Primary Care, 23(1), 71. https://doi.org/10.1186/s12875-022-01677-z
Singh, J. A., & Gaffo, A. (2020). Gout epidemiology and comorbidities. Seminars in Arthritis and Rheumatism, 50(3), S11–S16.
https://doi.org/10.1016/j.semarthrit.2020.04.008
Stamp, L. K., & Dalbeth, N. (2024). Moving urate-lowering therapy in gout beyond guideline recommendations. Seminars in Arthritis and Rheumatism, 65, 152358.
https://doi.org/10.1016/j.semarthrit.2023.152358
Tsiamalou, P., Brotis, A., Vrekou, E., Georgakopoulou, V., Papalexis, P., Aravanatinou‑Fatorou, A., Tegousi, M., Fotakopoulos, G., & Paterakis, K. (2023). The nurse’s role in managing gout in the modern era: A systematic review of the literature. Medicine International, 3(4), 40.
https://doi.org/10.3892/mi.2023.100
Xiao-xue, W., Yun, Z., Wei, Z., Qi, Z., Xue-jun, Z., & Xia, Z. (2019). Questionnaire survey for evaluating gout-related knowledge for nurses. Basic & Clinical Medicine, 39(9), 1376–1380.
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, 52(6), 1126–1131. https://doi.org/10.1093/rheumatology/kes431
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 International Journal of Clinical Science and Medical Research
This work is licensed under a Creative Commons Attribution 4.0 International License.