Document Detail

Uric acid lowering therapy: prescribing patterns in a large cohort of older adults.
MedLine Citation:
PMID:  17728328     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Uric acid lowering therapy (UALT) is considered a chronic treatment for gout. Relatively little is known about adherence to UALT.
METHODS: We assessed adherence with UALT over a 1-year study period among 9823 older adults enrolled in a pharmacy benefit program. Two adherence measures were calculated, the percentage of days covered (PDC) and the time until an extended break (at least 60 days) in treatment. A PDC <80% was considered poor adherence and its predictors were examined in multivariable logistic models.
RESULTS: The mean (SD) PDC was 54% (36%) with 64% of patients considered poorly compliant over the study period. A total of 56% had experienced an extended break in UALT. Predictors of poor adherence included younger age (odds ratio (OR) 1.50, 95% CI 1.33-1.69 for ages 65-74 compared with 85 and above) and African-American race (OR 1.86, 95% CI 1.52-2.27 compared with Caucasian race). Most patients (93%) received their initial UALT prescription from a non-specialist and this also predicted poor adherence (OR 1.15, 95% CI 0.96-1.38 compared with rheumatologists or nephrologists).
CONCLUSION: Adherence with UALT is poor. While uric acid levels were not measured in this study, poor adherence with UALT is likely to reduce attainment of goal uric acid levels.
D H Solomon; J Avorn; R Levin; M A Brookhart
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-29
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  67     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-14     Completed Date:  2008-11-14     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  609-13     Citation Subset:  IM    
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MeSH Terms
African Americans
Age Factors
Aged, 80 and over
Allopurinol / therapeutic use
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Cohort Studies
Drug Administration Schedule
Drug Therapy, Combination
European Continental Ancestry Group
Gout / drug therapy*,  ethnology,  psychology*
Gout Suppressants / therapeutic use*
Logistic Models
Patient Compliance*
Probenecid / therapeutic use
Sulfinpyrazone / therapeutic use
Grant Support
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Gout Suppressants; 63CZ7GJN5I/Allopurinol; PO572Z7917/Probenecid; V6OFU47K3W/Sulfinpyrazone

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