Adherence with urate-lowering therapies among male patients with gout in a routine clinical setting

Abstract

Objectives: To assess adherence (compliance and persistence) and factors that might contribute to nonadherence to urate-lowering therapies (ULT) in patients with gout in a routine clinical setting.

Methods: This prospective observational cohort study was conducted in the rheumatology center of a local tertiary hospital. A total of 132 male adults aged 75 years or younger who were incidentally diagnosed with gout were included. Adherence to ULT was assessed by the clinic nurses through pill counts.

Results: Of the 132 patients, 94 (71.2%) was compliant and 81 (61.4%) was persistent with ULT. The logistic regression analysis revealed that the absence of chronic kidney disease (CKD) and the previous history of non-persistence with ULT are the independent factors associated with noncompliance and the absence of CKD is an independent factor associated with non-persistence. The average serum urate levels of the noncompliant (p = 0.001) and non-persistent (p = 0.002) patients were significantly higher than those of the compliant and persistent patients.

Conclusions: The absence of CKD and the previous history of non-persistence of ULT that are correlated with poor adherence and easily assessed can be used to identify patients at a particular risk of poor adherence.

Keywords: Adherence; Compliance; Gout; Persistence.