Patient Attitudes Key to Effective Hyperuricemia Self-Management

A new study showed that patients with hyperuricemia had adequate knowledge of their condition, but effective self-management relied on stronger patient attitudes, especially in asymptomatic individuals.1

In this cross-sectional study conducted between July and August 2023, investigators sought to assess patients’ knowledge, attitudes, and practices regarding hyperuricemia and to examine the mediating role of attitude in different patient subgroups. The study analyzed questionnaires from 406 respondents, with most male (90.39%; n = 367).

The study showed patients with hyperuricemia had a high commitment to following medical recommendations, including adhering to medications, modifying diet, avoiding high-purine/high-fat foods, avoiding alcohol, hydrating, regularly exercising, and monitoring acid levels. However, fewer patients underwent regular CT scans or participated in peer support activities.

“These findings suggest a strong willingness among patients to actively participate in their own healthcare, which is a positive aspect for clinical practice,” wrote study investigator Hong Shi, from Shanxi Bethune Hospital in China, and colleagues. “To further enhance patient care, healthcare providers can build upon this motivation by emphasizing the importance of regular medical imaging and encouraging participation in group-based support.”

Knowledge, attitude, and practice scores were 54.34 ± 8.68 (possible range: 13—65), 23.40 ± 2.36 (possible range: 6—30), and 40.31 ± 4.92 (possible range: 10—50), respectively. Structural equation modeling revealed a significant direct effect of knowledge on attitude (P =.009) and a direct effect of attitude on practice (P =.015). Additionally, the analysis showed that knowledge had a significant indirect effect on practice mediated through attitude (P =.003). The study did not find a significant direct relationship between knowledge and practice (P = 0.317), only between knowledge and attitude.

“This suggests that while knowledge serves as a foundation, attitude is a crucial intermediary shaping behavior,” investigators wrote.

The team added that, because hyperuricemia is a metabolic risk factor and not just a symptomatic disease, patients need to focus on preventive strategies, including lifestyle modification, dietary counseling, appropriate urate-lowering therapy, and regular biochemical monitoring. A study earlier this year using a new machine learning prediction model reported that physical activity and less sedentary time reduced the risk of gout in people with hypouricemia.2

While Shi and colleagues’ study showed patients with hyperuricemia had a high commitment to following medical recommendations, the same was not always the case for asymptomatic patients.1 Many asymptomatic individuals underestimate the need for early prevention, whereas symptomatic patients view the disease as more serious and report higher attitude and practice scores.

Subgroup analyses showed that attitude played a stronger mediating role in patients without gout symptoms. In patients without gout, knowledge significantly influenced attitude (P = 0.009) and indirectly affected practice through attitude (P = 0.004); attitude also strongly impacted practice (P = 0.015). Conversely, in patients with gout symptoms, knowledge did not significantly influence attitude (P = 0.488) or practice (P = 0.509), though attitude still significantly affected practice (P = 0.025).1

Patients with comorbidities, such as hypertension or other chronic conditions, were associated with lower knowledge and attitude scores, indicating that competing health priorities may impact patient engagement. However, patients’ existing awareness of hyperuricemia offers a strong starting point for tailored education by healthcare providers.1

The study ultimately suggests that targeted educational interventions, such as dietary counseling, motivational interviewing, and support groups, may improve patients’ attitudes toward self-managing their hyperuricemia.1

“…it is recommended to institute regular follow-up appointments for monitoring and reinforcing adherence, implement tailored behavioral interventions that strengthen attitudinal engagement, especially in asymptomatic patients, develop individualized care plans, and bolster multidisciplinary collaboration among healthcare professionals,” investigators concluded.1 “In particular, clinical practices should focus on correcting misconceptions about preventive measures before gout onset, strengthening patients’ motivation for lifestyle modification, and encouraging participation in health education and peer-support programs, which were areas identified as relatively weaker in our findings.”

References

1. Shi H, Zhu Y, Guo Q, et al. Patients' knowledge influences practice via attitudes toward hyperuricaemia: a mediation analysis. Clin Rheumatol. Published online December 3, 2025. doi:10.1007/s10067-025-07813-1

2. Johnson V. Physical Activity and Sedentary Time Top Factors for Gout Risk in People With Hyperuricemia. HCPLive. April 30, 2025. Accessed December 10, 2025. https://join.hcplive.com/view/physical-activity-and-sedentary-time-top-factors-for-gout-risk-in-people-with-hyperuricemia