'It's just a great muddle when it comes to food': a qualitative exploration of patient decision-making around diet and gout.
Author
Liddle, JenniferRichardson, Jane C
Hider, Samantha L
Mallen, Christian D
Watson, Lorraine
Chandratre, Priyanka
Roddy, Edward
Affiliation
Newcastle University; University of Liverpool; Keele University; Sandwell and West Birmingham Hospitals NHS TrustPublication date
2021-08-13Subject
Rheumatology
Metadata
Show full item recordAbstract
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.Citation
Liddle J, Richardson JC, Hider SL, Mallen CD, Watson L, Chandratre P, Roddy E. 'It's just a great muddle when it comes to food': a qualitative exploration of patient decision-making around diet and gout. Rheumatol Adv Pract. 2021 Aug 13;5(3):rkab055.Type
ArticlePMID
34514294Publisher
Oxford University Pressae974a485f413a2113503eed53cd6c53
10.1093/rap/rkab055