Samantha Hider s.hider@keele.ac.uk
'It's just a great muddle when it comes to food': a qualitative exploration of patient decision-making around diet and gout.
Hider; Watson; Mallen; Roddy
Authors
Lorraine Watson l.watson@keele.ac.uk
Christian Mallen c.d.mallen@keele.ac.uk
Edward Roddy e.roddy@keele.ac.uk
Abstract
Objective: Our aim was to understand whether, why and how patients choose to modify their diets after developing gout.
Methods: We conducted an inductive thematic secondary analysis of qualitative data from 43 interviews and four focus groups with UK participants with gout (n?=?61).
Results: Participants commonly initiated dietary changes as part of a self-management strategy for gout. Reasons for making such dietary changes included: desperation; a desire for control; and belief that it would be possible to achieve successful management through diet alone; but not weight loss. Participants who did not make changes or who reverted to previous dietary patterns did so because: they believed urate-lowering therapy was successfully managing their gout; medication allowed normal eating; they did not find 'proof' that diet would be an effective treatment; or the dietary advice they found was unrealistic, unmanageable or irrelevant. Dietary modification was patient led, but patients would have preferred the support of a health-care professional. Beliefs that diet could potentially explain and modify the timing of flares gave patients a sense of control over the condition. However, the belief that gout could be controlled through dietary modification appeared to be a barrier to acceptance of management with urate-lowering therapy.
Conclusions: Perceptions about gout and diet play a large role in the way patients make decisions about how to manage gout in their everyday lives. Addressing the reasons why patients explore dietary solutions, promoting the value of urate-lowering therapy and weight loss and drawing on strong evidence to communicate clearly will be crucial in improving long-term clinical management and patient experience.
Acceptance Date | Aug 5, 2021 |
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Publication Date | Aug 31, 2021 |
Publicly Available Date | Mar 28, 2024 |
Journal | Rheumatology Advances in Practice |
Print ISSN | 2514-1775 |
Publisher | Oxford University Press |
DOI | https://doi.org/10.1093/rap/rkab055 |
Keywords | gout; inflammatory arthritis; diet; qualitative; patient experience; self-management; long-term condition |
Publisher URL | https://academic.oup.com/rheumap/article/5/3/rkab055/6350495 |
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