Improving adherence to gout therapy: an expert review

Abstract

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.

Consumption of 100% Tart Cherry Juice Reduces Serum Urate in Overweight and Obese Adults

“…Gout is a frequently occurring, complex rheumatologic form of inflammatory arthritis caused by the accumulation of serum uric acid (sUA) and deposition of uric acid crystals in the joints and tissues of the body (1). This deposition leads to heat, redness, and swelling with considerable accompanying tenderness and intense pain.…”

“…Fortunately, efficacious pharmacologic treatments are available for those with recurring gout (3–5). However, patient adherence to prescribed urate-lowering therapies (ULTs) ranges from 20% to 70%, suggesting that other additional strategies such as dietary intervention with specific, efficacious foods or beverages, e.g., tart cherry juice (TCJ) may be necessary to mitigate the risk of arthritis, as well as other comorbidities (1).…”

The Effect of Health Education on The Knowledge and Adherence of Diet for Gout Arthritis Patients

“…Penelitian serupa menunjukkan bahwa pengetahuan memiliki hubungan yang signifikan dengan kepatuhan diet penderita asam urat [21]. Semakin rendah tingkat pengetahuan tentang asam urat, maka semakin rendah kepatuhan pasien dalam menjalankan diet asam uratnya [22].…”

<p>How to Implement Adherence-Promoting Programs in Clinical Practice? A Discrete Choice Experiment on Physicians’ Preferences</p>

“…4,5 Adherence to medication is a complex and multidimensional behavior. 6 Therefore, direct engagement with patients is crucial to address any "adherence barriers." 3,7 Nevertheless, in real-world treatment settings, systematic interventions to measure and improve patients' adherence are rarely used.…”