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Gout Patient Education
Patient Education
- Patient education, appropriate lifestyle advice and shared decision making are core aspects of the management
- Often improves patient’s understanding and compliance when done at the start of therapy
- Educate patient regarding the disease, its treatment options, duration and side effects, and associated comorbidities
- Give advice on possible changes of life habits that can lead to an improvement in overall metabolic profile of the patient
- Patients should be made to understand that genetics contribute to risk factors more than indulgent food and drinks, therefore the need for urate-lowering therapy may be long-term
Lifestyle Modification
- The goal of lifestyle modification is to help prevent both gouty attacks and complications, together with its comorbidities
- It is a part of long-term management of gout
Body Mass Index (BMI)
- Aim to have ideal body weight through gradual weight loss (0.5-1 kg/week), with gradual caloric restriction and regular exercise
- Avoid “crash dieting” and high-protein/low-carbohydrate diets since these may cause ketosis and result to hyperuricemia
- Daily or at least 45-minute, 4-times-a-week, low-impact (eg walking, biking, swimming) or aerobic exercise is recommended
Dietary Management
- Dietary restriction can decrease the occurrence of gouty attacks but has little role in lowering serum urate levels in patients with gout
- Restrict consumption of high purine foods (eg brain, liver, kidney, anchovies, sardines, mackerel, seafood, shellfish)
- Reduce intake of meat (beef, lamb, pork)
- High intake of high-fiber fruits, vegetables, nuts, legumes, vegetable protein reduces the risk of gout (lower serum uric acid)
- Consumption of low-fat dairy products or skim milk up to 2 servings daily
- Limit sugar-sweetened softdrinks and beverages containing fructose
Alcohol Intake
- Restrict alcohol consumption to <21 units/week for men and 14 units/week for women
- Have at least 3 alcohol-free days/week
- Avoid alcohol intake when suffering from frequent gout attacks or when gout symptoms are poorly controlled
Smoking
- Complete cessation of smoking is recommended
Adequate Fluid Intake
- Recommended fluid intake is 2-3 L/day
- Restrict fluid intake in some patients (eg with heart failure or severe renal insufficiency)
