Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Apr 10;8(4):e017542.
doi: 10.1136/bmjopen-2017-017542.

Rate of adherence to urate-lowering therapy among patients with gout: a systematic review and meta-analysis

Rulan Yin #  1   2 , Lin Li #  3 , Guo Zhang #  4 , Yafei Cui  3 , Lijuan Zhang  3 , Qiuxiang Zhang  3 , Ting Fu  1 , Haixia Cao  5 , Liren Li  3 , Zhifeng Gu  1   5
Affiliations
Meta-Analysis

Rate of adherence to urate-lowering therapy among patients with gout: a systematic review and meta-analysis

Rulan Yin et al. BMJ Open. .

Abstract

Introduction: Reported adherence to urate-lowering therapy (ULT) in gout varies widely (17%-83.5%). Variability may partly be due to different adherence measurement methods. This review aimed to quantify ULT adherence in adult patients with gout.

Methods: This analysis examined studies in PubMed, Web of Science, CNKI Scholar and WanFang databases from inception to January 2017. Papers were selected by inclusion and exclusion criteria in the context. Random-effect meta-analysis estimated adherence.

Results: 22 studies were found by the inclusion criteria, which involved 1 37 699 patients with gout. Four ways to define adherence were reported. Meta-analysis revealed that the overall adherence rate was 47% (95% CI 42% to 52%, I2=99.7%). Adherence rate to ULT was 42% (95% CI 37% to 47%, I2=99.8%) for prescription claims, 71% (95% CI 63% to 79%) for pill count, 66% (95% CI 50% to 81%, I2=86.3%) for self-report and 63% (95% CI 42% to 83%, I2=82.9%) for interview, respectively. The influential factor on adherence rate was country of origin.

Conclusions: Among adult patients with gout, overall adherence rate to ULT was as low as 47%, which suggested that clinicians should pay more attention to medication adherence in patients with gout to effectively improve adherence to ULT.

Keywords: adherence; gout; meta-analysis; urate-lowering therapy.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart illustrating the article search process. First, we obtained 184 records identified through database searching, and 15 additional records identified through other sources. Second, 126 records remained after duplicates were removed. Third, 89 studies were excluded after records screening. Then the remaining 37 studies were assessed for eligibility of which 15 studies were excluded. Finally, 22 studies were included in the quantitative synthesis (meta-analysis).
Figure 2
Figure 2
Meta-analysis of per cent of adherent patients by method used to measure adherence. ES, effective size.
See this image and copyright information in PMC

References

    1. Roddy E, Doherty M. Epidemiology of gout. Arthritis Res Ther 2010;12:223 10.1186/ar3199 - DOI - PMC - PubMed
    1. Coburn BW, Bendlin KA, Sayles H, et al. Target serum urate: do gout patients know their goal? Arthritis Care Res 2016;68:1028–35. 10.1002/acr.22785 - DOI - PubMed
    1. Jordan KM, Cameron JS, Snaith M, et al. British society for rheumatology and british health professionals in rheumatology guideline for the management of gout. Rheumatology 2007;46:1372–4. 10.1093/rheumatology/kem056a - DOI - PubMed
    1. Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006;65:1312–24. 10.1136/ard.2006.055269 - DOI - PMC - PubMed
    1. Richette P, Bardin T. Gout. Lancet 2010;375:318–28. 10.1016/S0140-6736(09)60883-7 - DOI - PubMed

Publication types

LinkOut - more resources