Table 6.
Results of the main and sensitivity analyses of the effect of educational/behavioral intervention using fixed vs. random error and odds vs. risk ratio.
| Outcome or subgroup | # studies | Intervention versus control | Participants | Odds ratio (M–H, random, 95% CI); heterogeneity (I2%) |
Odds ratio (M–H, fixed, 95% CI); heterogeneity (I2%) |
Risk ratio (M–H, fixed, 95% CI); heterogeneity (I2%) |
Risk ratio (M–H, random, 95% CI); heterogeneity (I2%) |
|---|---|---|---|---|---|---|---|
| SU < 6 mg/dl | 4 | Pharmacist-led education and management versus usual care22
Primary care provider education versus usual care27 Pharmacist- led education and management versus usual care23 Nurse-led education versus general practitioner care24 |
2825 | 4.86 [1.48, 15.97]; 97% | 2.85 [2.42, 3.36]; 97% | 1.94 [1.74, 2.16]; 93% | 2.07 [1.31, 3.28]; 93% |
| SU < 5 mg/dl | 1 | Nurse-led education versus general practitioner care24 | 517 | 37.85 [22.96, 62.40]; N/A | 37.85 [22.96, 62.40]; N/A | 5.48 [4.14, 7.26]; N/A | 5.48 [4.14, 7.26]; N/A |
| Presence of tophi at 2 years | 1 | Nurse-led education versus general practitioner care24 | 517 | 0.27 [0.11, 0.63]; N/A | 0.27 [0.11, 0.63]; N/A | 0.29 [0.13, 0.65]; N/A | 0.29 [0.13, 0.65]; N/A |
| ULT adherent: PDC ⩾0.8 at 1 year | 1 | Pharmacist-led education and management versus usual care23 | 1412 | 1.66 [1.34, 2.05]; N/A | 1.66 [1.34, 2.05]; N/A | 1.34 [1.19, 1.52]; N/A | 1.34 [1.19, 1.52]; N/A |
| Being monitored with SU at 6 months | 1 | Primary care provider education versus usual care27 | 819 | 3.32 [2.45, 4.51]; N/A | 3.32 [2.45, 4.51]; N/A | 1.48 [1.33, 1.65]; N/A | 1.48 [1.33, 1.65]; N/A |
| Patients taking ULT at the end of the study period | 2 | (1). Primary care provider education versus usual care27
(2). Nurse-led education versus general practitioner care24 |
1336 | 5.91 [0.29, 120.97]; 98% | 2.61 [2.06, 3.30]; 98% | 1.40 [1.29, 1.52]; 97% | 1.44 [0.92, 2.25]; 97% |
| Achieving at least a 2 mg/dl decrease in SU at week 26 | 1 | Pharmacist-led education and management versus usual care22 | 77 | 4.26 [1.35, 13.44]; N/A | 4.26 [1.35, 13.44]; N/A | 3.03 [1.21, 7.58]; N/A | 3.03 [1.21, 7.58]; N/A |
| SMD (IV, random, 95% CI) | SMD (IV, fixed, 95% CI) | Mean difference (IV, fixed, 95% CI) | Mean difference (IV, random, 95% CI) | ||||
| Patient satisfaction visual analogue scale (0–100 mm) | 1 | Nurse-led education versus no education25 | 100 | 0.53 [0.13, 0.93]; N/A | 0.53 [0.13, 0.93]; N/A | 12.10 [3.28, 20.92]; N/A | 12.10 [3.28, 20.92]; N/A |
| Level of knowledge about gout (scale not reported) | 1 | Nurse-led education versus no education25 | 100 | 0.61 [0.21, 1.01]; N/A | 0.61 [0.21, 1.01]; N/A | 1.30 [0.47, 2.13]; N/A | 1.30 [0.47, 2.13]; N/A |
| Patient satisfaction questionnaire (scale not reported) | 1 | Nurse-led education versus no education25 | 100 | 0.78 [0.37, 1.19]; N/A | 0.78 [0.37, 1.19]; N/A | 0.31 [0.16, 0.46]; N/A | 0.31 [0.16, 0.46]; N/A |
| PDC at 1 year | 1 | Pharmacist-led education and management versus usual care23 | 1412 | 0.24 [0.14, 0.35]; N/A | 0.24 [0.14, 0.35]; N/A | 0.07 [0.04, 0.10]; N/A | 0.07 [0.04, 0.10]; N/A |
| Change in SU, mg/dl | 2 | (1). Pharmacist-led education and management versus usual care23
(2). Pharmacist-led education and management versus usual care22 |
1489 | −2.70 [−7.71, 2.30]; 99% | −0.23 [−0.34, −0.13]; 99% | −1.19 [−1.30, −1.08]; 99% | −0.96 [−2.22, 0.29]; 99% |
| Mean attack frequency during second year | 1 | Nurse-led education versus general practitioner care24 | 517 | −0.38 [−0.56, −0.21]; N/A | −0.38 [−0.56, −0.21]; N/A | −0.61 [−0.88, −0.34]; N/A | −0.61 [−0.88, −0.34]; N/A |
| SF-36 norm-based physical component scores | 1 | Nurse-led education versus general practitioner care24 | 517 | 0.22 [0.05, 0.39]; N/A | 0.22 [0.05, 0.39]; N/A | 3.44 [0.75, 6.13]; N/A | 3.44 [0.75, 6.13]; N/A |
| Ending dose of allopurinol | 2 | (1). Pharmacist-led education and management versus usual care23
(2). Nurse-led education versus general practitioner care24 |
1929 | 1.08 [−0.43, 2.58]; 99% | 0.63 [0.53, 0.72]; 99% | 72.22 [62.52, 81.92]; 100% | 130.77 [−63.26, 324.81]; 100% |
CI, confidence interval; IV, intravenous; M–H, Mantel-Haenszel test; PDC, proportion of days covered; SMD, standard mean difference; SU, serum urate; ULT, urate-lowering therapy.
N/A, not applicable, since these outcomes have only one study.