eCite Digital Repository

Medication adherence among patients with gout: A systematic review and meta-analysis


Scheepers, LEJM and van Onna, M and Stehouwer, CDA and Singh, JA and Arts, ICW and Boonen, A, Medication adherence among patients with gout: A systematic review and meta-analysis, Seminars in Arthritis and Rheumatism, 47, (5) pp. 689-702. ISSN 0049-0172 (2018) [Refereed Article]

Copyright Statement

Copyright 2018 Elsevier Inc. All rights reserved.

DOI: doi:10.1016/j.semarthrit.2017.09.007


Objective: In the management of chronic gout, a large proportion of patients need long-term management with urate lowering therapy (ULT). This study reviews medication adherence to ULT and summarizes factors associated with adherence.

Methods: We performed a systematic literature search for studies on adherence to ULT among gout patients in PubMed, Embase, CINAHL, and PsycINFO. We conducted meta-analysis, with a random effect model, for the studies reporting the proportion of patients considered adherent to at least 80% of prescribed medication or time taken. We explored potential sources of heterogeneity, including geographic area and measure of adherence. Narrative summaries were made for data on adherence assessed/defined by Medication Event Monitoring System (MEMS)/pill-count or patient-reported, occurrence of a gap in therapy ≥30 days (non-persistence), and factors associated with adherence.

Results: Of the 24 studies, 16 assessed adherence using prescription/claims data, two by the MEMS or pill count, and six by patient-reported data. The pooled proportion of adherent patients (n 13) was 46% (95% CI: 4151); 45% across studies conducted in the USA (n 8) and 48% in other countries (n 5). Adherence assessed by MEMS/pill count and patient-reported was much higher than by studies using prescription/claims data. Non-persistence (n 6) ranged from 54% to 87%. Factors associated with adherence were investigated in 18 studies. Strong evidence for a positive association with older age, more comorbidities, and the presence of diabetes or hypertension was found.

Conclusion: Medication adherence to ULT among gout patients was poor. Better insight into reasons and consequences or poor adherence is needed.

Item Details

Item Type:Refereed Article
Keywords:systematic literature review, meta-analysis, gout, allopurinol, adherence, compliance, persistence
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Scheepers, LEJM (Dr Lieke Scheepers)
ID Code:142403
Year Published:2018
Web of Science® Times Cited:74
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-01-14
Last Modified:2021-05-26

Repository Staff Only: item control page