Allopurinol adherence among patients with gout: an Italian general practice database study. Issue 7 (16th February 2015)

• Record Type: Journal Article
• Authors: Mantarro, S.; Capogrosso‐Sansone, A.; Tuccori, M.; Blandizzi, C.; Montagnani, S.; Convertino, I.; Antonioli, L.; Fornai, M.; Cricelli, I.; Pecchioli, S.; Cricelli, C.; Lapi, F.
• Is Part Of: International journal of clinical practice. Volume 69:Issue 7(2015)
• Page Start: 757
• Page End: 765
• Publication Date: 2015-02-16
• Subjects: Clinical medicine -- Periodicals; Medicine -- Periodicals; 610.5
• DOI: 10.1111/ijcp.12604
• Languages: English
• ISSNs: 1368-5031

Abstract

<abstract abstract-type="main" id="ijcp12604-abs-0001"> <title>Summary</title> <sec id="ijcp12604-sec-0001" sec-type="section"> <title>Aims</title> <p>Allopurinol is used as long‐term therapy to reduce the occurrence of gout flares. This study estimated the impact of patient adherence to allopurinol on hyperuricaemia (serum uric acid levels, sUA > 6 mg/dl) and the identification of non‐adherence predictors.</p> </sec> <sec id="ijcp12604-sec-0002" sec-type="section"> <title>Methods</title> <p>The Italian Health Search‐CSD Longitudinal Patient Database was accessed to identify outpatients aged ≥ 18 years with gout and prescribed with allopurinol during the years 2002–2011. Patients with a proportion of days covered ≥ 80% were considered adherent to allopurinol. Data on sUA levels over the first year of therapy were categorised in three time‐windows (30–89; 90–149; 150–365 days). Logistic regressions were used to estimate the association between adherence and hyperuricaemia, as well as non‐adherence predictors.</p> </sec> <sec id="ijcp12604-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 3727 patients were included. In the interval 0–29 days, the proportion of patients adherent to allopurinol was 45.9%, while up to 89, 149 and 365 days the percentages were 16.7%, 10.0% and 3.2%, respectively. The proportions of hyperuricaemic patients for each time‐window were 43.1%, 42.4%, 32.6% and 59.0%, 64.0%, 66.4% among adherent and non‐adherent patients, respectively. In the multivariable analysis, adherence was associated with a significant lower risk of hyperuricaemia. The adjusted ORs were 0.49 (95% CI: 0.33–0.73), 0.40 (95% CI: 0.24–0.67) and 0.23 (95% CI: 0.15–0.34) for the first, second and third time‐window, respectively. Patients with hypertension (adjusted OR = 0.64, 95% CI: 0.42–0.99) and history of gout flares (adjusted OR = 0.55, 95% CI: 0.32–0.95) were significantly adherent to allopurinol.</p> </sec> <sec id="ijcp12604-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>