ORIGINAL ARTICLEGout Medication Treatment Patterns and Adherence to Standards of Care From a Managed Care Perspective
Section snippets
Database
The study was conducted in a large southeastern US health plan database with 2.2 million patients at the time of the start of the study. The database included medical, pharmacy, and health plan eligibility data. Laboratory result data were available for a subset of the population. The types of health plans included health maintenance and preferred provider organizations. Data were available from January 1, 1999, to March 31, 2004.
Inclusion and Exclusion Criteria
Patients with either of the following 2 criteria for gout were
Patient Characteristics
A study cohort of 5942 patients with gout who were 18 years or older was identified. The prevalence of gout among all eligible patients in the study population was 1.6% (5942 of 369,356 eligible patients ≥18 years). Among patients eligible at any time who were 18 years or older, the prevalence of detected gout was 1.06% (21,404/2,017,633). Most patients (61.1%) were considered to have newly diagnosed gout because they had no medical or pharmacy claim for a gout-specific medication within 12
DISCUSSION
In the current study, 5942 eligible patients 18 years or older with medical claims for gout and/or pharmacy claims for gout-specific medications were identified from managed care data. The gout prevalence rate within the eligible members of the health plan was 1.6%. The overall prevalence of self-reported gout in the US National Health Interview Survey of 1996 among individuals older than 45 years was 4.6% in males and 2.0% in females.2 The National Institute of Arthritis and Musculoskeletal
CONCLUSION
In a large population of patients with gout, current urate-lowering medication options were not being used long term. Patients taking gout-specific medications had low allopurinol continuation rates and discontinued therapy relatively quickly. Allopurinol dosing appears to have been suboptimal to achieve the proposed target serum urate level of 6 mg/dL or lower; few patients received a modal daily dose higher than 300 mg/d. The 2 standards of care for clinical management of gout, recommended
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2022, Patient Education and CounselingCitation Excerpt :Rees et al. [24] featured an education intervention and tested SUA levels 12 months later. Two studies were follow-ups to previous education interventions with Mikuls et al. [25] being a randomized evaluation of a pharmacist-led intervention, while Abhishek et al. [26] featured a five year follow up questionnaire for a nurse-driven intervention. Sarawate et al. [27] was a retrospective claims analysis using logistic regression.
This study was funded by a grant from TAP Pharmaceutical Products Inc. Dr Patel and Dr Bakst are employees of TAP Pharmaceutical Products Inc. Mr Sarawate, is an employee of HealthCore, Inc; Mss Brewer and Yang are former employees of HealthCore, Inc.
Data were presented in part at the International Society for Pharmaco-economics and Outcomes Research 10th Annual Meeting, Washington, DC, May 14-16, and the American College of Rheumatology Annual Scientific Meeting, San Diego, Calif, November 12-17, 2005.