Table 6.

Monitoring/Managing stage literature review results.

Publication	Objective	Methods	Findings	Information Type	Conclusion
Roddy, Zhang, & Doherty [45]	Compare practices for chronic gout management in the UK to EULAR recommendations, including lifestyle advice and ULT therapy.	Questionnaire mailed to all patients over 30 in 2 general practices. Self-reported gout or acute arthritis attacks invited for clinical assessment.	Infrequent lifestyle modification advice.	lifestyle advice regarding weight loss, alcohol reduction, diet.	Advocates dissemination of EULAR recommendations for management.
Harrold, et al. [24]	Explore patient and provider views of ULDs for gout management.	Qualitative in-depth phone interviews of gout patients.	Patients recall being told to reduce certain foods, suggest follow up after initiating treatment.	lifestyle, treatment	Patients want more information about natural remedies.
Harrold, et al. [18]	Identify and understand patient gout knowledge, beliefs, and barriers to management.	Questionnaire about gout knowledge and beliefs.	Lack of knowledge regarding dietary triggers, ULT dosing during flares, risk of causing flares upon initiation. Deficit greater in those with active gout.	Lifestyle, treatment	Provide oral and written information regarding short- and long-term effects of ULTs and dietary factors throughout care.
Hui, et al. [43]	Revise and update recommendations for gout management in the UK.	The British Society for Rheumatology/Britis h Health Professionals in Rheumatology guideline for the management of gout	"All patients with gout should be given verbal and written information about the following: the causes and consequences of gout and hyperuricaemia; how to manage acute attacks; lifestyle advice about diet, alcohol consumption and obesity; and the rationale, aims and use of ULT to target urate levels. Management should be individualized and take into account comorbidities and concurrent medications. Illness perceptions and potential barriers to care should be discussed"	treatment, lifestyle	Updated recommendation due to better understanding of barriers to effective care
Ogdie, et al. [37]	Describe key points of intervention and propose educational improvements.	Review-no details	Patients need to understand that SUA levels under 6 mg/dl means unlikely to have gout and goal of therapy should be to maintain that level.	labs	Patient education may be most effective method to change physician behavior. Campaign with slogans to get patients to check their SUA levels.
Perez-Ruiz [16]	Review practices for long-term gout management w/emphasis on MSU crystals in pathogenesis and treating to target SUA level.	No explicit methodology.	The role of lifestyle changes and non-pharmacological approaches to gout management is essential information	lifestyle, treatment	These types of measures might only have a modest effect on sUA levels but are very beneficial for general health.
Johnston, et al. [41]	Review internationally available gout education resources to investigate content and ease of reading.	Analysis of written patient information content in 30 gout sources from several countries.	All sources noted role of uric acid, lifestyle factors such as weight, alcohol, and diet, including foods to avoid. Other topics not covered consistently.	Lifestyle, treatment, pathophysiology	"informing patients with gout of their increased risk of heart disease and diabetes is important for encouraging screening as well as modifying diet and lifestyle factors to manage risk. Providing patients with a target level for SUA may also prove important for tracking progress and maintaining motivation to take urate-lowering therapy during intercritical periods of gout."
Vaccher, et al. [40]	Investigate gout understanding and explore barriers to optimum care.	Inductive thematic analysis of semi-structured interviews about understanding of gout management.	Most patients have basic knowledge of gout and know some personal triggers of attacks, but do not understand medications or the earliest signs of an attack.	Pathophysiology, lifestyle, disease progression, treatment	Most patients do not recall receiving information about gout from their GP, leading them to research gout themselves and expressed a desire for more informative sources.
Jimenez-Liñan, et al. [42]	Assess content, readability, and accuracy of free online patient education materials as related to current gout knowledge.	Review of 30 online gout education resources	education resources often contain no or inaccurate information about pathogenesis and fail to emphasize the importance of ULT.	pathophysiology, treatment	Not many web-based sources provide accurate and easy to read information about gout.
Zangi, et al. [44]	Develop patient education recommendations for those with inflammatory arthritis and identify areas for further research.	An extensive systematic literature search in Medline, Embase, PsycINFO, Cochrane Library and CINAHL from January 2003 up to September 2013 of publications in English, German, French or Spanish describing any kind of PE activities, was conducted	Trend toward emphasis of behavioral, cognitive, and emotional processes in patient education	lifestyle, pathophysiology, disease progression	Eight recommendations with the overarching principle that patient education should enable people to manage their life and optimize health and well-being
Rifaat, et al. [39]	Identify patient knowledge gaps and concerns for inclusion in education initiative.	Needs assessment given to highly educated patients being seen by rheumatologists	Information of most interest was diet guidelines.	lifestyle	Major gaps in knowledge essential to self-management.
Abhishek & Doherty [46]	Highlight common knowledge gaps, recommend core knowledge for education, and review non-pharmacological strategies for gout management.	Systematic literature review: searched PubMed from inception to 28 March 2017	Gout patients have significant knowledge gaps. Lack of time to provide individualized education is one of the many barriers to care of gout.	pathophysiology, disease progression, treatment, lifestyle	"People with gout should be educated about the pathogenesis, associated comorbidities and management of gout, including both pharmacological and non-pharmacological management."
Fields & Batterman [47]	Explore literature on gout patient education suggest future research directions.	Literature review	Key concepts highlighted in the literature include genetic and metabolic causes of gout, the risk of progressive damage with inadequate treatment, goal serum urate levels and why they are monitored, rationale for short- and long-term management, impact of comorbidities, and dietary management.	pathophysiology, disease progression, treatment, lifestyle, labs	Optimal patient education requires multifaceted approach.