POS1437-PARE SUPPORT NEEDS OF GOUT PATIENTS AND SUITABILITY OF EHEALTH FOR (SELF-)MANAGEMENT OF GOUT
Authors: J. Van der Ven, B. Van den Bemt, F. Ariaans, J. E. Vriezekolk, M. Flendrie, L. M. Verhoef
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Despite the availability of effective medication for gout, management of gout remains suboptimal. Gout treatment may be improved by understanding patient's unmet needs for support in their disease management. Furthermore, eHealth may be suitable to deliver support in a personalized and cost-effective way. However, it is unknown what support gout patients need and how eHealth can support these needs. <h3>Objectives:</h3> To investigate the support needs of patients with gout using urate-lowering therapy and explore the suitability of eHealth applications to address those needs. <h3>Methods:</h3> A qualitative focus group study was conducted at the Sint Maartenskliniek, Nijmegen, the Netherlands. A total of 23 gout patients with urate-lowering therapy, treated by a rheumatologist, general practitioner (GP), or no longer under treatment, participated in three 2-hour focus group sessions. Participants were recruited via rheumatologists or among previous study participants based on purposive sampling (age, sex, and disease duration). Initially, patients wrote two tips (points for improvement) and tops (positive experiences) about their care, leading to in-depth discussions on unmet needs. Following this, patients were queried about the suitability and their preferences of eHealth in addressing these needs. Audio recordings were transcribed verbatim and transcriptions were thematically analyzed by two researchers and reflected upon by two other authors, providing a specific story for each generated theme. <h3>Results:</h3> Gout patients expressed five key support needs (Figure 1): 1) Timely access to healthcare, especially during flares. 2) (Personalized) information regarding diagnosis, medication, and diet. 3) Insight into health through monitoring, where patients desired more insight into treatment (side)-effects by more frequent blood monitoring and periodic follow-up visits with healthcare providers (e.g. GPs or rheumatologists). 4) Active patient engagement, where patients mentioned that they desire an active role in treatment, including the need to be prepared for flares and self-monitoring of serum uric acid (sUA) levels at home. 5) Better coordination across primary and secondary care, emphasizing the need for quicker referrals from GPs to specialized care and clarity on roles and responsibilities. In terms of eHealth related to these support needs, patients suggested digital accessibility to care and ordering and receiving medication (on the weekend), Artificial Intelligence to answer questions, a central platform for uniform and reliable information, digital information sessions and newsletters, self-monitoring sUA and digital medication reminders. Three themes emerged about the suitability of eHealth in gout care (Figure 1): 1) Attitudes towards eHealth in gout care, where patients were positive toward functions like asking questions and communicating with HCPs, and the possibility of accessing a large body of knowledge. Negative attitudes included concerns about: privacy, controllability of digital systems, who is keeping track of patients' medical records, and differences in the interpretation of digital information between the elderly and young people. 2) Supportive role of eHealth in gout care. While acknowledging potential benefits, eHealth should be viewed as an addition to care, instead of a replacement thereof, due to trust in HCPs and importance of personal contact. 3) Preferences regarding use of eHealth and its functionalities in gout care; preferences included a digital gout platform with up-to-date information and individualized medication information upon logging in and different communication options dependent on the topic and type of question (Figure 1). <h3>Conclusion:</h3> Based on the results of this study, we have formulated several points to consider to guide the development of a patient-centered eHealth application, taking into account patient's needs, perspectives and preferences (Figure 1). This may ultimately contribute to more patient-centered, sustainable and affordable gout care. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Jeffrey van der Ven: None declared, Bart van den Bemt: None declared, Floor Ariaans: None declared, Johanna E. Vriezekolk Lilly Netherlands BV, Marcel Flendrie: None declared, Lise M. Verhoef: None declared.