Improving adherence to gout therapy: an expert review

Figures & data

Figure 1 The five dimensions of poor adherence.

Notes: Adapted from World Health Organization. Adherence to long-term therapies. Evidence for action. Available from: http://www.who.int/chp/knowledge/publications/adherence_report/en/.¹⁴
Abbreviation: WHO, World Health Organization.

Table 1 Methods used to measure adherence to gout therapy

Indirect methods

• Patient questionnaires

• Physician questionnaires

• Morisky Medication Adherence Scale

Direct methods

• Counting dosage units

• Pill counts

• Pharmacy data

• Medical records

• Medication event monitoring system

• Biochemical measurements

Table 2 Summary of studies worldwide on adherence to ULT

Author (reference)	Country	No of patients	Notes	Main finding
Kuo et al,^Citation3 2015	UK	115,608	Reference year 2012	40% of patients were found to be adherent or partially adherent to ULT
McGowan et al,^Citation20 2016	Ireland	34,634	Adherence was defined as continued use of therapy with no periods exceeding a refill gap of >63 days	45.8% and 22.6% of patients were adherent at 6 and 12 months, respectively
Zandman-Goddard et al,^Citation37 2013	Israel	7,644	Drug adherence >80%	17% were adherent to allopurinol over a 2-year period
Mantarro et al,^Citation38 2015	Italy	3,727	≥80% days covered considered adherent	3.2% of patients remained adherent to allopurinol after 1 year
Dehlin et al,^Citation40 2017	Sweden	7,709	Age <50 years, lack of comorbidities, and “normal kidney function” or “end-stage kidney failure” were associated with non-adherence with ULT	Of patients starting ULT, only 25% were adherent within 2 years

Abbreviation: ULT, urate-lowering therapies.

Figure 2 Barriers and facilitators of adherence to chronic gout medications.

Abbreviation: QoL, quality of life.

Figure 3 Factors identified as associated with good adherence in patients using ULT for gout.

Abbreviation: ULT, urate-lowering therapies.

WHOAdherence to long-term therapies. Evidence for action Available from: http://www.who.int/chp/knowledge/publications/adherence_report/en/Accessed April 16, 2018

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