Patient journey mapping-guided intervention improves metabolic markers and self-management in young and middle-aged adults with hyperuricemia: a randomized controlled trial

Background Hyperuricemia (HUA) is increasingly prevalent among young and middle-aged adults, who often demonstrate poor illness perception and low treatment adherence. Patient Journey Mapping (PJM) offers a patient-centered approach to identify unmet needs, but its application in HUA management remains unexplored. This study aimed to develop and evaluate a PJM-based multiphase health behavior intervention for this population. Methods This single-center, parallel-group randomized controlled trial recruited 150 young and middle-aged HUA patients randomly assigned to intervention (n=75) or control (n=75). The intervention group received a PJM-based multiphase intervention across three stages: symptom awareness, diagnosis and early treatment, and long-term self-management. The primary outcome was the serum uric acid (SUA) level at 6 months; secondary outcomes included SUA target achievement, BMI, illness perception (BIPQ), and self-management (AHSMSRS), assessed at baseline and 1, 3, and 6 months. Results Compared with the control group, the intervention group showed significantly lower SUA levels and higher SUA target achievement rates at 1, 3, and 6 months, significantly lower BIPQ scores at 1, 3, and 6 months, and significantly higher AHSMSRS scores at 3 and 6 months. A supportive observed complete-case analysis also showed lower BMI at 6 months. At 6 months, the intervention group showed significantly lower SUA (314.51 ± 70.16 vs. 350.88 ± 73.11 μmol/L, P = 0.002; Cohen’s d=0.508), higher SUA target achievement (observed complete-case: 86.3% vs. 69.0%, P = 0.013; pooled ITT risk difference 18.7 percentage points, 95% CI 5.1 to 32.3, P = 0.009), lower BMI (supportive observed complete-case analysis: 24.07 ± 2.50 vs. 25.36 ± 2.88 kg/m 2 ; mean difference −1.29 kg/m 2 , t = 2.873, P = 0.005), improved illness perception (BIPQ: 25.45 ± 2.78 vs. 30.40 ± 2.33, P<0.001), and enhanced self-management (AHSMSRS: 140.43 ± 26.22 vs. 121.53 ± 38.41, P = 0.001). Repeated measures ANOVA revealed significant time, group, and interaction effects (P<0.05). BIPQ and AHSMSRS scores were negatively correlated at all time points. Conclusions The PJM-based intervention may improve metabolic markers, illness perception, and self-management in young and middle-aged adults with HUA, suggesting potential feasibility for outpatient nursing practice, although findings require confirmation in multi-center trials with more diverse samples. No adverse events were reported or detected during the 6-month intervention period. Clinical trial registration http://www.chictr.org.cn , identifier ChiCTR2300074011.