Patients’ knowledge influences practice via attitudes toward hyperuricaemia: a mediation analysis

Patients diagnosed with hyperuricaemia exhibited adequate knowledge and generally positive attitudes, which met the 70% cut-off value standard. The findings confirmed a full mediation effect, where knowledge influences practice through attitude, with this pathway being more evident among asymptomatic patients. Improving patient attitudes, especially in those without gout symptoms, should remain a key target for tailored educational and behavioral interventions to promote consistent self-management practices. Key Points • Patients with asymptomatic hyperuricaemia often underestimated the importance of preventive measures, reflected in lower attitude scores, whereas patients with gout symptoms demonstrated significantly higher knowledge, attitude, and practice scores. • Comorbidities such as hypertension or other chronic conditions were associated with lower knowledge and attitude scores, suggesting that competing health priorities may modify patient engagement. • Knowledge influenced practice indirectly through attitude, underscoring the importance of attitudinal improvement as a mediator in patient self-management. • Targeted educational interventions, such as dietary counseling, motivational interviewing, and peer-support groups, may strengthen patient attitudes and promote sustained self-management.