Nursing Guidance Improves Outcomes in Patients with Gout and Concomitant Hypertension

Published on: February 20, 2024

Patients receiving a nursing intervention had significantly better response rates, improvements in anxiety and depression scores, and significantly higher patient satisfaction when compared with the conventional care group.

A comprehensive nursing intervention was shown to improve quality of life, treatment outcomes, mood, and patient satisfaction in a cohort of elderly patients with gout and hyperuricemia who had concomitant hypertension, according to a study published in Pakistan Journal of Medical Sciences.¹

Key Takeaways

The study included 120 elderly patients with concomitant gout, hyperuricemia, and hypertension, randomized into an experimental cohort receiving comprehensive nursing intervention and a control cohort receiving conventional nursing care.
The nursing intervention, focusing on diet control, disease cognition, exercise, and psychological guidance, led to better response rates (85% vs. 70%) and significantly improved indicators of interest post-intervention.
The experimental group exhibited significant decreases in SAS and SDS levels, along with a higher patient satisfaction rate (92% vs. 78%) compared to the control group.
Limitations included a homogeneous patient population.
The integrated nursing intervention model, providing targeted interventions at every stage, was deemed effective in improving the treatment effect and positively impacting patients' psychological well-being.

These findings are “of high reference value in clinical nursing and is worth promoting in the clinical practice,” wrote a group of investigators from Baoding No.1 Central Hospital in Baoding, China.

A diagnosis of gout and hyperuricemia with concomitant hypertension is common among elderly patients. Elevated blood pressure and uric acid can result in cardiac, renal, cerebral, and systemic vascular damage, as well as more severe complications such as stroke, heart failure, and myocardial infarction. In fact, this combination of conditions is the primary risk factor for cardiovascular mortality.²

The clinical comparative study enrolled 120 elderly patients with gout, hyperuricemia and comorbid hypertension who were admitted to Baoding No. 1 Central Hospital between March 20, 2021 and March 20, 2022. Eligible patients had clinically diagnosed gout, met the diagnostic criteria for hypertension, were aged > 65 years, and had good treatment compliance and complete clinical data.

These patients were randomized into 2 groups: the comprehensive nursing intervention program (experimental cohort) and conventional nursing care in the perioperative period (control cohort). In addition to conventional gout treatment, the nursing intervention focused on helping patients with diet control, enhancing disease cognition, and providing exercise and psychological guidance. Clinical effects and quality of life were evaluated and compared between groups.

The Generic Quality of Life Inventory-74 (GQOLI-74) assessed physical function, psychological function, physical living status, and social function. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) evaluated any emotional changes pre- and post-intervention, and the Patient Satisfaction Questionnaire Short Form (PSQ-18) determined patient satisfaction.

The experimental group included 35 female patients and 25 male patients, with an average age of 69.87 years, while the control group enrolled 33 female patients with 27 male patients, with an average age of 70.57 years.

At baseline, no statistically significant differences were reported regarding social functioning, material life status score, physical functioning, and psychological functioning between groups (P >.05). Similarly, no significant differences in SAS and SDS levels were observed between groups pre-intervention (P >.05).

The experimental group had significantly better response rates when compared with controls (85% vs 70%, respectively, P = .03). Post-intervention, investigators observed statistically significant improvements in the indicators of interest for those receiving the comprehensive intervention (P = .00). Additionally, patients in the experimental group had significant decreases in SAS and SDS levels (P = .00) and a significantly higher patient satisfaction rate compared with the conventional care group (92% vs 78%, respectively, P = .04).

The sample size comprised of a homogeneous patient population were noted as limitations of the study. Future research will include young and middle-aged patients and an extended follow-up period.

“It can be seen that the integrated nursing intervention model can improve the treatment effect because it is completely integrated into the treatment, allowing patients to receive targeted interventions at every stage, which is important to improve the treatment effect,” investigators concluded. “The care model also makes [patients] feel valued, which has a positive psychological impact on them.”

References

^{Liu J, Lu N, Shen S, Zhang W. Effect of comprehensive nursing intervention on quality of life and treatment outcomes in elderly patients with Gout and Hyperuricemia complicated with hypertension. Pak J Med Sci. 2024;40(3Part-II):358-363. doi:10.12669/pjms.40.3.7535}
^{Kaul S, Gupta M, Bandyopadhyay D, Hajra A, Deedwania P, Roddy E, et al. Gout Pharmacotherapy in Cardiovascular Diseases: A Review of Utility and Outcomes. Am J Cardiovasc Drugs. 2021;21(5):499-512. doi: 10.1007/s40256-020-00459-1}