Article Text

PDF
Uric acid lowering therapy: prescribing patterns in a large cohort of older adults
  1. D H Solomon,
  2. J Avorn,
  3. R Levin,
  4. M A Brookhart
  1. Division of Pharmacoepidemiology, Division of Rheumatology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  1. D H Solomon, Division of Pharmacoepidemiology, 1620 Tremont Street, Suite 3030, Boston MA 02120, USA; dhsolomon{at}partners.org

Abstract

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.

Statistics from Altmetric.com

Footnotes

  • Funding: Savient Pharmaceuticals Inc. supported this study.

  • Competing interests: None declared.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.