{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:16:37Z","timestamp":1777482997978,"version":"3.51.4"},"reference-count":65,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,8,25]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Gout is increasing despite effective therapies to lower serum urate concentrations to 0.36\u2009mmol\/L or less, which, if sustained, significantly reduces acute attacks of gout. Adherence to urate-lowering therapy (ULT) is poor, with rates of less than 50% 1\u2009year after initiation of ULT. Attempts to increase adherence in gout patients have been disappointing. We aim to evaluate the effectiveness of use of a personal, self-management, \u2018smartphone\u2019 application (app) to achieve target serum urate concentrations in people with gout. We hypothesise that personalised feedback of serum urate concentrations will improve adherence to ULT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:sec>\n                     <jats:title>Setting and design<\/jats:title>\n                     <jats:p>Primary care. A prospective, cluster randomised (by general practitioner (GP) practices), controlled trial.<\/jats:p>\n                  <\/jats:sec>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>GP practices will be randomised to either intervention or control clusters with their patients allocated to the same cluster.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention<\/jats:title>\n                  <jats:p>The intervention group will have access to the Healthy.me app tailored for the self-management of gout. The control group patients will have access to the same app modified to remove all functions except the Gout Attack Diary.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcomes<\/jats:title>\n                  <jats:p>The proportion of patients whose serum urate concentrations are less than or equal to 0.36\u2009mmol\/L after 6 months. Secondary outcomes will be proportions of patients achieving target urate concentrations at 12 months, ULT adherence rates, serum urate concentrations at 6 and 12 months, rates of attacks of gout, quality of life estimations and process and economic evaluations. The study is designed to detect a \u226530%\u2009improvement in the intervention group above the expected 50% achievement of target serum urate at 6 months in the control group: power 0.80, significance level 0.05, assumed \u2018dropout\u2019 rate 20%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This study has been approved by the University of New South Wales Human Research Ethics Committee. Study findings will be disseminated in international conferences and peer-reviewed journal.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ACTRN12616000455460.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017281","type":"journal-article","created":{"date-parts":[[2024,5,16]],"date-time":"2024-05-16T17:25:53Z","timestamp":1715880353000},"page":"e017281","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Effectiveness of an electronic patient-centred self-management tool for gout sufferers: a cluster randomised controlled trial protocol"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6045-6937","authenticated-orcid":false,"given":"Richard O","family":"Day","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology & Toxicology, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"St Vincent\u2019s Clinical School, St Vincent\u2019s Hospital, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren J","family":"Frensham","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology & Toxicology, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"St Vincent\u2019s Clinical School, St Vincent\u2019s Hospital, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy D","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology & Toxicology, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"St Vincent\u2019s Clinical School, St Vincent\u2019s Hospital, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa T","family":"Baysari","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology & Toxicology, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eindra","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology & Toxicology, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"St Vincent\u2019s Clinical School, St Vincent\u2019s Hospital, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annie Y S","family":"Lau","sequence":"additional","affiliation":[{"name":"Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Zwar","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Reath","sequence":"additional","affiliation":[{"name":"School of Medicine, Western Sydney University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5182-9092","authenticated-orcid":false,"given":"Tracey","family":"Laba","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia"},{"name":"The Menzies Centre for Health Policy, Sydney Medical School, The University of Sydney, Sydney, Australia"},{"name":"The Centre for Clinical Epidemiology and Evaluation, The University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Li","sequence":"additional","affiliation":[{"name":"Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy and Centre for Education and Research on Ageing, University of Sydney, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William B","family":"Runciman","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of South Australia, Adelaide, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachelle","family":"Buchbinder","sequence":"additional","affiliation":[{"name":"Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robyn","family":"Clay-Williams","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6444-6584","authenticated-orcid":false,"given":"Enrico","family":"Coiera","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Braithwaite","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H Patrick","family":"McNeil","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-752X","authenticated-orcid":false,"given":"David J","family":"Hunter","sequence":"additional","affiliation":[{"name":"Institute of Bone and Joint Research, Kolling Institute, Sydney Medical School, The University of Sydney, Sydney, Australia"},{"name":"Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin D","family":"Pile","sequence":"additional","affiliation":[{"name":"Department of Medicine, Western Sydney University, Sydney, Australia"},{"name":"Department of Rheumatology, Campbelltown Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Portek","sequence":"additional","affiliation":[{"name":"St George and Sutherland Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia"},{"name":"Department of Rheumatology, St George Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth Mapson","family":"WIlliams","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology & Toxicology, St Vincent\u2019s Hospital, Sydney, Australia"},{"name":"St Vincent\u2019s Clinical School, St Vincent\u2019s Hospital, University of New South Wales, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna I","family":"Westbrook","sequence":"additional","affiliation":[{"name":"Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,10,16]]},"reference":[{"key":"2025101812021798000_7.10.e017281.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13075-016-1062-6","article-title":"Incidence and prevalence of gout in Western Sweden","volume":"18","author":"Dehlin","year":"2016","journal-title":"Arthritis Res Ther"},{"key":"2025101812021798000_7.10.e017281.2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.024091"},{"key":"2025101812021798000_7.10.e017281.3","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/acr.22660","article-title":"Prevalence of Gout in the Adult Population of France","volume":"68","author":"Bardin","year":"2016","journal-title":"Arthritis Care Res"},{"key":"2025101812021798000_7.10.e017281.4","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.91"},{"key":"2025101812021798000_7.10.e017281.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00346-9"},{"key":"2025101812021798000_7.10.e017281.6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150310"},{"key":"2025101812021798000_7.10.e017281.7","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.ypmed.2015.10.003","article-title":"Gout and its comorbidities in the total population of Stockholm","volume":"81","author":"W\u00e4ndell","year":"2015","journal-title":"Prev Med"},{"key":"2025101812021798000_7.10.e017281.8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-143-7-200510040-00009"},{"key":"2025101812021798000_7.10.e017281.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2007.00173.x"},{"key":"2025101812021798000_7.10.e017281.10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem150"},{"key":"2025101812021798000_7.10.e017281.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.081604"},{"key":"2025101812021798000_7.10.e017281.12","doi-asserted-by":"publisher","DOI":"10.1186\/ar4589"},{"key":"2025101812021798000_7.10.e017281.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.02.004"},{"key":"2025101812021798000_7.10.e017281.14","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080487"},{"key":"2025101812021798000_7.10.e017281.15","first-page":"341","article-title":"Gout: epidemiology and lifestyle choices","volume":"17","author":"Choi","year":"2005","journal-title":"Curr Opin Rheumatol"},{"key":"2025101812021798000_7.10.e017281.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0800885"},{"key":"2025101812021798000_7.10.e017281.17","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft029"},{"key":"2025101812021798000_7.10.e017281.18","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/1471-2474-15-174","article-title":"Hyperuricaemia: a marker of increased cardiovascular risk in rheumatic patients: analysis of the ACT-CVD cohort","volume":"15","author":"Meek","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"key":"2025101812021798000_7.10.e017281.19","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203325"},{"key":"2025101812021798000_7.10.e017281.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.01.004"},{"key":"2025101812021798000_7.10.e017281.21","doi-asserted-by":"publisher","DOI":"10.1186\/ar2978"},{"key":"2025101812021798000_7.10.e017281.22","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22336"},{"key":"2025101812021798000_7.10.e017281.23","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150607"},{"key":"2025101812021798000_7.10.e017281.24","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160614"},{"key":"2025101812021798000_7.10.e017281.25","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200801"},{"key":"2025101812021798000_7.10.e017281.26","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-201687"},{"key":"2025101812021798000_7.10.e017281.27","doi-asserted-by":"publisher","DOI":"10.1592\/phco.28.4.437"},{"key":"2025101812021798000_7.10.e017281.28","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1186\/s12891-016-1252-z","article-title":"Illness perceptions of gout patients and the use of allopurinol in primary care: baseline findings from a prospective cohort study","volume":"17","author":"Walsh","year":"2016","journal-title":"BMC Musculoskelet Disord"},{"key":"2025101812021798000_7.10.e017281.29","doi-asserted-by":"crossref","first-page":"182","DOI":"10.5694\/j.1326-5377.1993.tb137784.x","article-title":"Preventing acute gout when starting allopurinol therapy. Colchicine or NSAIDs?","volume":"159","author":"Kot","year":"1993","journal-title":"Med J Aust"},{"key":"2025101812021798000_7.10.e017281.30","doi-asserted-by":"publisher","DOI":"10.1002\/art.34488"},{"key":"2025101812021798000_7.10.e017281.31","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.091327"},{"key":"2025101812021798000_7.10.e017281.32","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1376"},{"key":"2025101812021798000_7.10.e017281.33","unstructured":"Lau AY , Parker A , Early J , et al . Comparative usage of a web-based personally controlled health management systemnormal support: a case study in IVF. Online J Public Health Inform 2012."},{"key":"2025101812021798000_7.10.e017281.34","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000433"},{"key":"2025101812021798000_7.10.e017281.35","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ijmedinf.2016.06.021","article-title":"Mobile applications to enhance self-management of gout","volume":"94","author":"Nguyen","year":"2016","journal-title":"Int J Med Inform"},{"key":"2025101812021798000_7.10.e017281.36","first-page":"28","article-title":"A user-centred approach to designing an etool for gout management","volume":"227","author":"Fernon","year":"2016","journal-title":"Stud Health Technol Inform"},{"key":"2025101812021798000_7.10.e017281.37","unstructured":"NationalAssociation of Testing Authorities. https:\/\/www.nata.com.au\/nata\/"},{"key":"2025101812021798000_7.10.e017281.38","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00400.x"},{"key":"2025101812021798000_7.10.e017281.39","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080506"},{"key":"2025101812021798000_7.10.e017281.40","doi-asserted-by":"publisher","DOI":"10.1002\/hec.866"},{"key":"2025101812021798000_7.10.e017281.41","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199304050-00006"},{"key":"2025101812021798000_7.10.e017281.42","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-83"},{"key":"2025101812021798000_7.10.e017281.43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1467-842X.2005.tb00227.x"},{"key":"2025101812021798000_7.10.e017281.44","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-6-20"},{"key":"2025101812021798000_7.10.e017281.45","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.05.007"},{"key":"2025101812021798000_7.10.e017281.46","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyl129"},{"key":"2025101812021798000_7.10.e017281.47","doi-asserted-by":"crossref","first-page":"A650","DOI":"10.1016\/j.jval.2015.09.2338","article-title":"An Economic Evaluation to Assess the Cost Effectiveness of the New Medicine Service in Improving Adherence in People Initiated on New Treatment for Gout","volume":"18","author":"Brinkmann","year":"2015","journal-title":"Value in Health"},{"key":"2025101812021798000_7.10.e017281.48","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199813040-00003"},{"key":"2025101812021798000_7.10.e017281.49","first-page":"165","article-title":"Cost-effectiveness analysis of allopurinol versus febuxostat in chronic gout patients: a U.S. payer perspective","volume":"21","author":"Gandhi","year":"2015","journal-title":"J Manag Care Spec Pharm"},{"key":"2025101812021798000_7.10.e017281.50","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1258"},{"key":"2025101812021798000_7.10.e017281.51","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-3-201302050-00583"},{"key":"2025101812021798000_7.10.e017281.52","unstructured":"Identification as a cluster randomised trial in the title. http:\/\/www.consort-statement.org\/checklists\/view\/651-cluster-trials\/846-title."},{"key":"2025101812021798000_7.10.e017281.53","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2015.02.004"},{"key":"2025101812021798000_7.10.e017281.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.curtheres.2013.04.003"},{"key":"2025101812021798000_7.10.e017281.55","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3181945d2c"},{"key":"2025101812021798000_7.10.e017281.56","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2012.01.020"},{"key":"2025101812021798000_7.10.e017281.57","unstructured":"Cochrane Consumers and Communication Review Group. Cluster randomised controlled trials. Cochrane Consumers and Communication Review Group, 2014. http:\/\/cccrg.cochrane.org."},{"key":"2025101812021798000_7.10.e017281.58","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050100"},{"key":"2025101812021798000_7.10.e017281.59","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1071\/PY03044","article-title":"Coaching for behaviour change in chronic disease: a review of the literature and the implications for coaching as a self-management intervention","volume":"9","author":"Lindner","year":"2003","journal-title":"Aust J Prim Health"},{"key":"2025101812021798000_7.10.e017281.60","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.chb.2015.12.023","article-title":"Using feedback through digital technology to disrupt and change habitual behavior: a critical review of current literature","volume":"57","author":"Hermsen","year":"2016","journal-title":"Comput Human Behav"},{"key":"2025101812021798000_7.10.e017281.61","first-page":"1","article-title":"Medication adherence measures: an overview","volume":"2015","author":"Lam","year":"2015","journal-title":"Biomed Res Int"},{"key":"2025101812021798000_7.10.e017281.62","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.12557"},{"key":"2025101812021798000_7.10.e017281.63","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035700"},{"key":"2025101812021798000_7.10.e017281.64","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"2025101812021798000_7.10.e017281.65","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv183"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2017-017281","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T19:02:27Z","timestamp":1760814147000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2017-017281"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10]]},"references-count":65,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2017,10,16]]},"published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1136\/bmjopen-2017-017281"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2017-017281","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10]]}}}