Annals of the Rheumatic Diseases 2008;67:609-613
EXTENDED REPORTS
Uric acid lowering therapy: prescribing patterns in a large cohort of older adults
Division of Pharmacoepidemiology, Division of Rheumatology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
D H Solomon, Division of Pharmacoepidemiology, 1620 Tremont Street, Suite 3030, Boston MA 02120, USA; dhsolomon{at}partners.org
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.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Rider, T. G., Jordan, K. M.
(2009). The modern management of gout. Rheumatology (Oxford)
0: kep306v1-kep306
[Abstract] [Full Text] -
Singh, J A, Hodges, J S, Asch, S M
(2009). Opportunities for improving medication use and monitoring in gout. Ann Rheum Dis
68: 1265-1270
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
-
All Versions of this Article:
ard.2007.076182v1
67/5/609 most recent - Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
