What Can Patients with Gout Buy Online? The Availability of Self-Management Products for Singaporean Patients Vu C.H.K.*1, Yeong Z.G.M.T.*1, Goldsmith L.J.1, Tan D.1, Burrell S.1, Smith H.E.1 *Co-Principal Authors 1 Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Introduction Study Aim: To explore and categorise gout products available to patients online. • Gout, an inflammatory arthritis, is increasing in prevalence. • A sizeable minority of patients prefer non-pharmacological Methods approaches and diet modifications for gout management. • Searched for “gout” products in six websites: AliExpress, , eBay, Lazada, , . • Patients obtain self-management products through a • Multiple coders evaluated products for relevance to gout and identified duplicates. Discrepancies variety of means, including online sources. between coders were resolved by consensus. • Qualities evaluated: category of product, presence of cautions for use and approval by regulatory bodies Table 1: All products, unfiltered & filtered for relevance to gout Table 2: Gout-related products by Table 3: Percentage of oral and topical gout-related Gout-related product type (duplicates removed) products missing safety details (duplicates removed) Gout-related All products, Traditional Missing cautions Missing approval by products Topical Monitoring products duplicates removed n (row %) Herbal Others* for use regulatory bodies n(col %, row %) Treatments Devices n(col %, row %) Therapies Western 44 73 All websites 1426 1092(100,77) 543(100,38) All websites 279(51) 96(18) 70(13) 98(18) Pharmaceuticals eBay 574 508(47,89) 155(29,27) eBay 120(77) 16(10) 1(1) 17(11) Traditional Herbal 72 96 Lazada 297 239(22,80) 146(27,49) Lazada 35(24) 41(28) 43(30) 27(19) Therapies Shopee 302 207(19,69) 145(27,48) Shopee 81(56) 22(15) 9(6) 40(23) Vitamin & Mineral 39 89 Qoo10 76 67(6,88) 49(9,64) Qoo10 31(63) 6(12) 6(12) 6(12) Supplements AliExpress 146 47(4,32) 28(5,19) AliExpress 6(21) 6(21) 11(39) 5(19) Topical 73 99 Carousell 31 24(2,77) 20(4,65) Carousell 6(30) 5(25) 0(0) 9(45) Treatments * includes low urate food & drink (n=26, 5% of total), information (n=20, 4%), vitamin & mineral supplements (n=18, 3%), western Discussion pharmaceuticals (n=11, 2%), orthotics (n=11, 2%), combination of traditional herbal therapies & vitamin & mineral supplements (n=7, 1%) • Patient success in finding gout self-management products overall and by specific types of products will vary by e-commerce site. In our study, for example, eBay returned the most gout-related products and highest sensitivity rate. AliExpress had the lowest sensitivity rate with less than 1/3 of products being gout-related. • Given the possibility of adverse interactions or side effects, the absence of cautions for use for Western Pharmaceuticals and Traditional Herbal Therapies, coupled with access to the former without a prescription, were of most concern. Contact : [email protected] • Clinicians should be aware of the variety of potential risks patients face in using e-commerce for sourcing gout self-management product. & [email protected]