| Author,year, country | Design | N | Duration, months | Details of intervention | Outcomes |
|---|---|---|---|---|---|
| Murphy and Schumacher, 1984US24 | RCT | 63 | 24 | Randomly assigned to four educational groups:A: education by rheumatology fellowB: pamphlet on goutC: intensive education by nurseD: monthly telephone call from nurse | Mean SU levels:No change A & B (initial: 8.3 mg/dl to final: 8.2 mg/dl). Improved C & D (initial: 8.8 mg/dl to final: 6.4 mg/dl) |
| Lim et al, 2012Singapore21 | QIP | 126 | 12 | Comprehensive patient education, enhanced telephone access for nurses to call patients, reappointments and refills, increased frequency of visits until target SU concentration achieved | Median time to achieve target SU (<6 mg/dl) was 36.9 weeks with 72% of patients achieving that by 12 months |
| Rees et al, 2013UK25 | Observ | 106 | 12 | Education, individualised lifestyle advice, appropriate ULT | 92% achieved therapeutic target (<6 mg/dl after 1 year) |
| Abhishek et al, 2017UK12 | Observ | 75 | 60 | Questionnaire sent to 100 patients with gout from previous study25 to examine adherence of ULT by nurse-led care | 5-year persistence on ULT was 91%. Of these, 85% had SU level <5 mg/dl after 5 years |
| Yoo et al, 2017South Korea28 | RCT[Abstract] | 100 | 3 | Patient education randomly assigned to education and non-education groups. Intervention group received nurse-led face-to-face education. Both groups: information leaflet, and ULT | Increased knowledge, improved drug compliance, target SU decreased (5.73 cf 6.08 mg/dl) in education versus non-education group |
| Tay et al, 2017Singapore27 | Observ [Abstract] | 100 | 9 | Telemedicine bundle: nurse education, six 2-weekly phone calls, hotline; 6-weekly lab tests and couriered ULT | Median time to achieve target SU levels 19 weeks, no hospitalisation gout flares |
| Doherty et al, 2018UK14 | RCT | 517 | 24 | Randomly assigned to nurse-led care educating patients and involved in management decisions or usual care by GPs | Nurse versus GP groups at 2 years:SU levels <6 mg/dl 95% cf 29%. 88% cf 16% SU <5 mg/dl.Presence of tophi r3% cf 11% (P<0.0001)Risk of flares 8% cf 25% (P<0.0001)Quality of life SF-36 physical component 41 cf 37 (P<0.0001) |
| Latif et al, 2019UK19 | Qual | 30 | 4 | Participants involved in observational study25 interviewed to explore patient perception of nurse-led care | Nurse-led cf to GP care reported improved knowledge and understanding of ULT, leading to long-term adherence to ULT by patients |
Cf = Compare. Observ = observational. Qual = qualitative. QIP = quality improvement project. RCT = randomised controlled trial. SU = serum urate. ULT = urate lowering therapy. Vs = versus. Wk = week.