Almost half of gout patients are not taking their medication

Almost half of patients with gout are not adherent to their urate-lowering medication, a survey conducted in South Australia shows.

While two thirds of people with a diagnosis of gout say they have been prescribed allopurinol, only 55% continued with treatment, according to responses obtained from the South Australian Health Omnibus Survey conducted in 2015.

The population-based survey of more than 2500 people interviewed face to face found the self-reported gout prevalence to be 6.8%. The mean age of respondents with gout was 64 years and 82% were male.

When asked about use of allopurinol, 36% of gout patients said they were currently using the drug and 29% said they had previously used it. Patients were not asked about febuxostat as it had only just been made available for funding and was restricted to second line use in gout.

Predictors of adherence to urate-lowering medication included  male gender, low socioeconomic status and concomitant cholesterol lowering therapy. People with a higher BMI were also more likely to remain on urate-lowering medication, which the study authors said might be related to the higher propensity for gout attacks in more obese people.

The study authors, from the Department of Rheumatology, The Queen Elizabeth Hospital, Adelaide, note the 6.8% prevalence of gout found in the 2015 survey is slightly higher than the figure of 5.8% recorded in a previous 2008 survey carried out in South Australia.

“It is of some concern that, despite evidence that effective management of chronic gout requires treatment with long-term [urate-lowering therapy], only 55% of respondents with gout who had ever used allopurinol, remained current users,” they write in Arthritis Research and Therapy.

“Gout is both an under-appreciated cause of morbidity in the community, and an eminently treatable condition, and further research is required to identify barriers and appropriate clinical management/communication strategies to optimise effective care,” they conclude.

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