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Improving adherence to gout therapy: an expert review

Authors Perez-Ruiz F, Desideri G

Received 18 January 2018

Accepted for publication 3 April 2018

Published 3 May 2018 Volume 2018:14 Pages 793—802

DOI https://doi.org/10.2147/TCRM.S162956

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Hoa Le

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh


Fernando Perez-Ruiz,1 Giovambattista Desideri2

1Rheumatology Division, Cruces University Hospital, Baracaldo, Spain; 2Geriatric Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy


Abstract: Gout is the most common form of inflammatory arthritis and is a considerable burden to patients and health care systems worldwide. Despite its clinical, economic, and social impact, patient persistence and adherence to prescribed urate-lowering therapies (ULT), ranging from 20% to 70%, is considered to be among the poorest of all chronic conditions. The majority of gout patients consequently receive suboptimal benefits of their prescribed pharmacotherapies. As gout is associated with several comorbidities along with an increased risk of premature mortality, achieving improved outcomes through adherence to ULT is crucial. Adherence to medication is complex and multidimensional and includes a combination of treatment-, patient-, and physician-related factors. This review explores the factors related to ULT adherence with the overall aim of helping health care providers better understand the barriers to adherence. Several interventions targeting pharmacists, nurses, and patients are being investigated to improve adherence. Furthermore, enhanced awareness and understanding of the need to treat-to-target in order to improve patient outcomes is needed among health care professionals. Greater understanding of the multidimensional nature of non-adherence can help physicians to treat gout more effectively and empower patients to improve self-management of this long-term disease.

Keywords: treatment, gout suppressants, persistence, monitoring

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