Allopurinol adherence among patients with gout: an Italian general practice database study

Mantarro, Stefania; Capogrosso-Sansone, Alice; Tuccori, Marco; Blandizzi, Corrado; Montagnani, Sabrina; Convertino, Irma; Antonioli, Luca; Fornai, Matteo; Cricelli, Iacopo; Pecchioli, Serena; Cricelli, Claudio; Lapi, Francesco

doi:10.1111/ijcp.12604

Cited by 32 publications

(22 citation statements)

References 39 publications

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“…However, this reduced to 41% at the 1-year mark. 7 A review of national health records in the USA showed that only half of those with gout who were receiving ULT achieved their target. 4 Published studies show that medication adherence is low in patients with gout on ULT.…”

Section: Discussionmentioning

confidence: 99%

“…1 Despite the availability of multiple urate-lowering therapies (ULT), the rate at which patients in general practice and the general community achieve their urate targets is low and medication non-adherence is prevalent. 1,2,4,[6][7][8] Data from gout-oriented rheumatology practices are scant but potentially important to the understanding of factors that influence the rate of achieving target urate levels.…”

Section: Introductionmentioning

confidence: 99%

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Achieving serum urate targets in gout: an audit in a gout-oriented rheumatology practice

2017

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Achieving serum urate targets in gout: an audit in a gout-oriented rheumatology practice

2017

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“… 20 In addition, a large retrospective study in Israel showed that only 17% were adherent to allopurinol, 37 while in Italy, only 3.2% of patients remained adherent to allopurinol after 1 year. 38 In a gout-oriented rheumatology practice in Australia, failing to reach target sUA was almost always due to non-adherence. 39 Finally, a recent population-based cohort study from Sweden of 7,709 gout patients confirmed that long-term adherence was poor.…”

Section: Adherence In Goutmentioning

confidence: 99%

Improving adherence to gout therapy: an expert review

Pérez-Ruiz¹,

Desideri²

2018

TCRM

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Gout is the most common form of inflammatory arthritis and is a considerable burden to patients and health care systems worldwide. Despite its clinical, economic, and social impact, patient persistence and adherence to prescribed urate-lowering therapies (ULT), ranging from 20% to 70%, is considered to be among the poorest of all chronic conditions. The majority of gout patients consequently receive suboptimal benefits of their prescribed pharmacotherapies. As gout is associated with several comorbidities along with an increased risk of premature mortality, achieving improved outcomes through adherence to ULT is crucial. Adherence to medication is complex and multidimensional and includes a combination of treatment-, patient-, and physician-related factors. This review explores the factors related to ULT adherence with the overall aim of helping health care providers better understand the barriers to adherence. Several interventions targeting pharmacists, nurses, and patients are being investigated to improve adherence. Furthermore, enhanced awareness and understanding of the need to treat-to-target in order to improve patient outcomes is needed among health care professionals. Greater understanding of the multidimensional nature of non-adherence can help physicians to treat gout more effectively and empower patients to improve self-management of this long-term disease.

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“…Scheepers et al reported mean PDC of 0.57 (standard deviation (SD) ±0.34) for patients with ≥1 diagnosis, while Coburn et al selected patients with ≥2 diagnoses and reported median PDC 0.7 to 0.83 [23, 38]. The proportion with PDC≥80 in the first year was 38.6% among patients with ≥1 diagnosis [27, 39] and 59% among patients with ≥1 diagnosis validated through a survey [40]. MPR was only measured using a liberal definition [41].…”

Section: Resultsmentioning

confidence: 99%

Variation in methods, results and reporting in electronic health record-based studies evaluating routine care in gout: A systematic review

et al. 2019

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ObjectiveTo perform a systematic review examining the variation in methods, results, reporting and risk of bias in electronic health record (EHR)-based studies evaluating management of a common musculoskeletal disease, gout.MethodsTwo reviewers systematically searched MEDLINE, Scopus, Web of Science, CINAHL, PubMed, EMBASE and Google Scholar for all EHR-based studies published by February 2019 investigating gout pharmacological treatment. Information was extracted on study design, eligibility criteria, definitions, medication usage, effectiveness and safety data, comprehensiveness of reporting (RECORD), and Cochrane risk of bias (registered PROSPERO CRD42017065195).ResultsWe screened 5,603 titles/abstracts, 613 full-texts and selected 75 studies including 1.9M gout patients. Gout diagnosis was defined in 26 ways across the studies, most commonly using a single diagnostic code (n = 31, 41.3%). 48.4% did not specify a disease-free period before ‘incident’ diagnosis. Medication use was suboptimal and varied with disease definition while results regarding effectiveness and safety were broadly similar across studies despite variability in inclusion criteria. Comprehensiveness of reporting was variable, ranging from 73% (55/75) appropriately discussing the limitations of EHR data use, to 5% (4/75) reporting on key data cleaning steps. Risk of bias was generally low.ConclusionThe wide variation in case definitions and medication-related analysis among EHR-based studies has implications for reported medication use. This is amplified by variable reporting comprehensiveness and the limited consideration of EHR-relevant biases (e.g. data adequacy) in study assessment tools. We recommend accounting for these biases and performing a sensitivity analysis on case definitions, and suggest changes to assessment tools to foster this.

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Allopurinol adherence among patients with gout: an Italian general practice database study

Abstract: Adherence monitoring in patients with gout is pivotal to ensure the effectiveness of therapy. To gain a better patient adherence, the communication between physicians and patients should be improved.

Cited by 32 publications

References 39 publications

Achieving serum urate targets in gout: an audit in a gout-oriented rheumatology practice

Achieving serum urate targets in gout: an audit in a gout-oriented rheumatology practice

Improving adherence to gout therapy: an expert review

Variation in methods, results and reporting in electronic health record-based studies evaluating routine care in gout: A systematic review

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