Skip to main content

Research Repository

Advanced Search

Implication of nurse intervention on engagement with urate-lowering drugs: a qualitative study of participants in a RCT of nurse led care

Latif, Zahira P.; Nakafero, Georgina; Jenkins, Wendy; Doherty, Michael; Abhishek, Abhishek

Implication of nurse intervention on engagement with urate-lowering drugs: a qualitative study of participants in a RCT of nurse led care Thumbnail


Authors

Zahira P. Latif

Wendy Jenkins

Michael Doherty



Abstract

Objectives To explore patient perception of the role of a nurse-led complex package of care in facilitating engagement with urate-lowering therapies (ULTs) in the management of gout.
Methods Thirty people who had participated in a randomised controlled trial investigating the effect of a nurse-led complex package of care for gout, were purposively sampled and interviewed between 18–26 months after the end of the trial. Interviews were recorded, transcribed and analysed using a modified grounded-theory approach. Data were managed using Nvivo. STATA v15 was used to describe summary statistics.

Results Participants described their views and experiences of engaging with a nurse-led intervention designed to provide holistic assessment, individualised patient education, and involvement in shared decision-making for the long-term management of gout. The analysis revealed key themes in how nurse-led intervention facilitated engagement with ULT, namely by proving improved knowledge and understanding of gout and its treatment, involvement of patients in decision-making about treatment, and increased confidence about benefits from treatment. However, some treatment uncertainty and concern remained and one participant free of gout flares discontinued ULT, while another halved the dose after the end of the trial.

Conclusions This study reports data on patient experience of engaging with ULT to manage gout after receiving nurse-led care. It demonstrates that shared decision-making and the joint efforts of fully informed practitioners and patients persuades patients to engage with ULTs, and that experiencing the benefits of curative treatment motivates them to maintain adherence.

Journal Article Type Article
Acceptance Date Oct 17, 2018
Online Publication Date Oct 27, 2018
Publication Date May 31, 2019
Deposit Date Nov 12, 2018
Publicly Available Date Oct 28, 2019
Journal Joint Bone Spine
Print ISSN 1297-319X
Electronic ISSN 1778-7254
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 86
Issue 3
Pages 357-362
DOI https://doi.org/10.1016/j.jbspin.2018.10.008
Keywords Urate-lowering therapy; Gout; Nurse-led intervention; Medication adherence; Clinical inertia; Therapeutic education
Public URL https://nottingham-repository.worktribe.com/output/1241990
Publisher URL https://www.sciencedirect.com/science/article/pii/S1297319X18301672?via%3Dihub