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Doubts, cost cited for lack of urate-lowering therapy adherence among African-American gout patients
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Facilitators and barriers to high urate-lowering therapy adherence in African-American patients with gout, including drug effectiveness and cost, were identified in a recent study.
Researcher Jasvinder A. Singh, MD,MPH, department of medicine at the School of Medicine and Division of Epidemiology, University of Alabama, Birmingham, studied 43 African-American patients with gout (mean age, 63.9 years; 67% men) who participated in nine nominal groups, a variant on focus groups. The sessions lasted up 1.5 hours, with six focusing on patients with low urate-lowering therapy (ULT) adherence and three centered on patients with high ULT adherence (medication possession rations of <0.80 or ≥0.80, respectively). Patients discussed and ranked their concerns, and qualitative analysis was conducted.
Preventing gout flares, preventing pain from becoming chronic or severe, having less dietary restriction, lack of side effects from ULT, trusting their physicians and avoiding the need for urgent or emergency care for flares were patients’ reasons for ULT adherence. By organizing medications through pillbox use and incorporating ULT intake into a daily routine, patients were able to achieve high adherence.
“The main barriers to optimal ULT adherence were: doubts about effectiveness of ULT, concerns about cost and side effects, concomitant medications, forgetfulness, refilling the prescription on time, pill size and difficulty in swallowing, competing priorities … and frequent travel,” Singh wrote.
“This study provides and in-depth insight into facilitators and barriers to ULT adherence in African-Americans with gout,” he concluded. “Several new themes were identified in this study. This new knowledge should serve as a foundation for research of behavioral and nonbehavioral interventions to improve ULT adherence in minorities with gout.”
Disclosure: Singh reports no relevant financial disclosures.
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