Effectiveness of pharmacist-led interventions in improving gout outcomes: A systematic review

BACKGROUND: Pharmacists are core members of the healthcare team, offering essential support beyond dispensing of medications. They play a crucial role in managing and educating patients, particularly those with chronic diseases. Although numerous studies have reported the involvement of pharmacists in the care of people living with gout, the overall evidence remains limited and is not well defined. OBJECTIVES: This systematic review aims to evaluate the impact of pharmacist-led interventions in improving gout outcomes in people living with gout, specifically focusing on serum uric acid levels, medication adherence, and patient education. METHODS: A comprehensive search was conducted on multiple electronic databases including PubMed, Ovid Embase and Cochrane (library) central to identify relevant studies published up to April 2025. The studies eligible for this review included randomized controlled trials (RCTs), and non-randomized studies (non-RCTs), including pre-post studies and cohort designs that assessed pharmacist-led interventions in the management of gout. Outcomes of interest were reductions in serum uric acid levels, prevention of gout flares, absolute serum uric acid reductions, required dosage to achieve target serum uric acid level, improvements in patient education and frequency of clinic visits. The risk of bias for RCTs was assessed by utilizing the ROB-2 tool, while non-randomized studies were assessed with the ROBINS-I tool. RESULTS: Five studies involving a total of 1805 people living with gout were included in this review. In these studies, pharmacists delivered interventions such as provided interventions; enhancing patient education or providing pharmaceutical care either alone or in collaboration with other healthcare team members were included. Two studies were RCTs, while three were non-RCTs. Pharmacist-led interventions contributed to achieving target serum uric acid levels, determining appropriate the dose of urate lowering therapy needed to attain target levels, improving adherence, and reducing gout flares. The randomized trials were found to have lower risk compared to non-randomized studies. CONCLUSION: The findings suggested that pharmacist involvement in gout management can considerably enhance disease control and improve the overall quality of life for patients. Further research is warranted to identify the most effective components of pharmacist-led interventions and to evaluate their effect on gout outcomes.