Nurse-supported self-monitoring of serum urate by gout patients using a treat-to-target approach: a feasibility study

To assess the feasibility of a nurse-supported, treat-to-target (T2T) self-monitoring approach for gout patients initiating urate-lowering therapy (ULT) using point-of-care testing (POCT) of serum urate levels. A 24-week prospective feasibility study was conducted at the Sint Maartenskliniek in the Netherlands among 32 patients starting ULT, or recently started ULT and not at target. Participants received a POCT device to self-measure serum urate levels at home and report results every four weeks via a digital platform. Nurses provided education and dosing advice based on serum urate levels and monitored patient follow-up. Feasibility was assessed using Bowen’s framework. Patient data were obtained through questionnaires and chart review, stakeholder perspectives were collected through semi-structured interviews. Patients found the intervention highly acceptable. Adherence to serum urate measurements was 93%, with minimal burden and few problems reported. The majority of the patients reached their serum urate target (75%). Patients had a median of 2 gout flares (IQR 0—3). Stakeholders valued the intervention for the potential to increase patient engagement and care efficiency, though they emphasized the need for evidence on cost-effectiveness, clear protocols and appropriate patient selection. Nurse-supported self-monitoring for gout was acceptable, feasible, and practical in this selected group of gout patients. The short-term serum urate target attainment was encouraging, warranting larger comparative randomized studies with longer follow-up to establish (cost-) effectiveness, and long term disease control.