AB0105 ‘..THERE’S TOO MUCH TO PUT IN A LEAFLET’: A QUALITATIVE EXPLORATION OF STAKEHOLDER VIEWS OF LIFESTYLE INTERVENTIONS FOR GOUT
Authors: L. Watson, N. Cornwall, C. Jinks, K. Bradbury, L. Goff, P. Little, C. Mallen, E. Roddy
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Lifestyle has been associated with gout for centuries and dietary triggers of flares remain of great interest to people with gout. However, there is a lack of robust clinical trial evidence about the effectiveness of lifestyle change in people living with gout. There is also a paucity of qualitative research exploring the views of people living with gout or healthcare professionals on lifestyle (including diet, alcoholic drinks, and physical activity) interventions for gout. <h3>Objectives:</h3> To explore stakeholder views on lifestyle interventions for gout to inform development of an intervention for future evaluation. <h3>Methods:</h3> People living with gout were identified via social media and posters in the community. General practitioners, primary care nurses, dietitians and health and wellbeing coaches were identified via social media, professional bodies, and professional networks. Informed consent was obtained from participants prior to a one-to-one semi-structured interview conducted via the telephone or Microsoft Teams. Participants were offered a £20 shopping voucher for taking part. Interviews (December 2022- March 2023) were analysed using inductive reflexive thematic analysis. Ethical approval: Keele University REC Project Reference 0411. Stakeholder Community of Practice (COP) and Patient and Public Involvement and Engagement (PPIE) groups shared their views on the findings of the interviews and are involved in the co-design of the lifestyle intervention. <h3>Results:</h3> People with gout (n=16), general practitioners (n=4), primary care nurses (n=2), dietitians (n=5) and health and wellbeing coaches (n=4) were interviewed. Themes identified included '<b><i>Lack of priority</i></b>' Insufficient time, staff and finance, no quality standard for gout, and more information and support available for other conditions; '<b><i>Hearing and sharing</i></b>' Want to hear and share experiences of other people with gout, and the benefits of lay involvement, peer support, groups and online forums; '<b><i>Fitting in real life</i></b>' Social and cultural role of alcoholic drinks, challenge of fitting physical activity in everyday life, and intervention delivery and content which may help or hinder fitting lifestyle change into real life; '<b><i>Impact of and on Gout and Comorbidities</i></b>' Potential impact of gout and comorbidities on engagement with a lifestyle intervention, and of taking part in an intervention on gout and comorbidities; '<b><i>Holistic</i></b>' A range of information and support required including medication and wellbeing, access to other services, and that anyone who has experience, knowledge, and qualifications could deliver intervention; '<b><i>Individualised and personalised</i></b>' Preference for personalised approach, benefits of one to ones before groups, and that people feel dietary triggers for flares are individual; '<b><i>Information needs</i></b><i>'</i> Importance of information needs to allow people to make decisions and support change; '<b><i>Changing the narrative</i></b><i>'</i> Aspects of intervention have potential to change narrative around gout (e.g. address stigma, lack of evidence, myths and misconceptions). COP and PPIE group discussed how the findings may impact on the purpose, content and format of a new lifestyle intervention. <h3>Conclusion:</h3> The themes identified in this qualitative exploration of stakeholder views will inform the development of a new lifestyle intervention for people living with gout. This study will help the lifestyle intervention address issues, and challenges crucial to meeting stakeholder's needs. An intervention developed from this research can be tested in a future pilot and feasibility study. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> The authors would like to thank the study participants, members of the stakeholder community of practice, and the PPIE group for their involvement in this research project. Funding statement: Lorraine Watson is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research (SPCR) [Post-doctoral Fellowship Grant reference PID-210149]. Clare Jinks and Christian Mallen are part funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands. Christian Mallen is funded by the NIHR SPCR. Katherine Bradbury is funded by NIHR ARC Wessex. 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. <h3>Disclosure of Interests:</h3> <b>None declared.</b>