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]
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 ¼ 13) was 46% (95% CI: 41–51); 45% across studies conducted in the USA (n ¼ 8) and 48% in other countries (n ¼ 5). Adherence assessed by MEMS/pill count and patient-reported was much higher than by studies using prescription/claims data. Non-persistence (n ¼ 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 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 Group:||Clinical health|
|Objective Field:||Treatment of human diseases and conditions|
|UTAS Author:||Scheepers, LEJM (Dr Lieke Scheepers)|
|Web of Science® Times Cited:||42|
|Deposited By:||Menzies Institute for Medical Research|
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