P102 Barriers and facilitators to lifestyle change in people living with gout: a scoping review of qualitative studies
Authors: Watson Lorraine , Cornwall Nicola , Jinks Clare , Bradbury Katherine , Goff Louise , Little Paul , Mallen Christian D , Roddy Edward 
Published: April 2023

Abstract

Background/Aims
Lifestyle, especially diet and alcohol, has been implicated in the causation of gout for centuries and the dietary factors which may trigger flares remain of great interest to people living with gout and their families. However, there is a lack of robust clinical trial evidence about the effectiveness of lifestyle change in people living with gout. The aim of this review was to establish the thoughts, feelings and experiences of people with gout, partners and healthcare professionals about gout, to identify barriers and facilitators to behaviours relating to lifestyle change (diet, alcohol, and physical activity) in people living with gout.

Methods
A scoping review was undertaken following the stages recommended in Arksey & O’Malley’s scoping studies methodological framework. Databases Embase, MEDLINE, CINAHL, PsycINFO and AMED were searched from January 2000 to October 2021 to identify qualitative studies in gout. Themes were identified within the results of included qualitative studies using thematic synthesis (coding text in the results and then developing themes) and were discussed with both a stakeholder community of practice (COP) group and a patient and public involvement and engagement (PPIE) group.

Results
1871 title/abstracts and 158 full papers were screened and 38 qualitative studies in gout were identified. Themes identified in the scoping review are presented in Table 1 and were corroborated with COP and PPIE group members. Examples of potential barriers to lifestyle change in people with gout include poor knowledge, confusing or inadequate information, uncertainty about effectiveness of diet in gout management, stigma, and a reluctance to see healthcare professionals. Potential facilitators for lifestyle change include the desire to prevent flares and pain, the provision of information, and that people with gout already search for information and avoid or consume certain foods.

Conclusion
This is the first scoping review to identify potential barriers and facilitators to behaviours relating to lifestyle change in people living with gout. Potential barriers include poor knowledge, problems with current information and stigma. The findings will be used to inform the development of the new lifestyle intervention for people living with gout in primary care.
Disclosure
L. Watson: Grants/research support; Lorraine Watson is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research. [Post-doctoral Fellowship Grant reference 2020-347], this (abstract) presents independent research funded by the NIHR. The views expressed are those of the author(s) and not necessarily those of the (partner organisation), the NHS, the NIHR or the Department of Health and Social Care. N. Cornwall: None. C. Jinks: Grants/research support; Clare Jinks is part funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands. K. Bradbury: Grants/research support; Katherine Bradbury is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Wessex. L. Goff: None. P. Little: None. C.D. Mallen: Grants/research support; Christian Mallen is funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands and the NIHR School for Primary Care Research, The School of Medicine as received funding from BMS for a non-pharmacological AF screening trial, Christian Mallen has received grant funding from Wellcome and the Medical Research Council. E. Roddy: None.