Using Gout Buddy to Enhance Dietary Literacy and Gout Management-A Mixed Method Clinical Trial

Background and Rationale:

Gout is a chronic and progressive form of inflammatory arthritis characterized by the accumulation of urate crystals in the joints, leading to recurrent episodes of severe pain, redness, and swelling. It is primarily caused by hyperuricemia, a condition in which there is an excess of uric acid in the blood. Gout is more common in men and older adults and is often associated with comorbidities such as hypertension, diabetes, and cardiovascular disease.

A 2015 meta-analysis of global gout studies estimated a pooled prevalence of 0.6%, though with significant variation. [1] In mainland China, the prevalence of gout from 1998 to 2019 was 1.6%, and a local study from Singapore among Chinese individuals found that 4.1% had a history of physician-diagnosed gout. [2,3] Despite the availability of effective treatments, about one-third patients struggle with managing their condition.[4] Poor control can be attributed due to lack of understanding of gout's etiology, progression, and the importance of adherence to prescribed therapies. [5] Poor management of gout can result in frequent flare-ups, joint damage, and decreased quality of life.

Research indicates that patient education significantly impacts the successful management of gout. [6] However, traditional methods of patient education-such as pamphlets, infrequent consultations, and group sessions-often fall short in engaging patients and providing timely information tailored to their individual needs. [7,8] Additionally, these methods do not accommodate the continuous need for information that patients may have outside of clinic hours. Therefore, there is a need for innovative, accessible, and patient-centered educational tools that can bridge these gaps and empower patients to manage their gout more effectively.

Digital health interventions have emerged as a promising solution to these challenges. By leveraging technology, these interventions can provide continuous support, personalized information, and interactive educational content to patients. [9] Chatbots, in particular, have gained attention for their efficacy of health behaviour change among large and diverse population. [10] Chatbots can be particularly beneficial in chronic disease management, where ongoing patient education and engagement are critical. By providing instant access to reliable information and guidance, chatbots can help patients better understand their condition, adhere to treatment plans, and make informed decisions about their health.