Background Medication adherence is important to treatment success, particularly in gout where the target level achievement is critical. However, there is no evidence that mobile phone text message reminder is effective in improving treatment adherence and clinical outcomes for gout.

Objectives To evaluate the effect of mobile phone text messaging on the adherence to allopurinol treatment and serum uric acid (SUA) level of patient with gout in a randomized-controlled trial.

Methods Adult patients who were diagnosed of gout by 1977 ARA classification criteria for gout, receiving at least 1 month of allopurinol, and had estimated glomerular filtration rate greater than 30 mL/min/1.73 m² were enrolled and randomly assigned to 2 groups by block randomization. Patients in the intervention group received a daily short message reminder to take allopurinol for 90 days. Patients in the control group received a weekly short message information about non-pharmacologic treatment for gout in plain language. The primary outcomes were allopurinol adherence, defined as the Medication Taking Behaviour for Thai patient (MTB-Thai) score >21, and SUA level at 12 weeks. The primary analysis was by intention-to-treat. This trial is registered with Thai Clinical Trials Registry, TCTR20171229004.

Results Eighty-two patients were randomised, with 42 in the intervention group and 40 in the control group. No significant different of baseline characteristic, SUA (7.66±1.24 vs 7.78±1.17 mg/dL) and MTB-Thai score (18.38±0.73 vs 18.37±0.95) between two groups. At week 12, 37 patients (88.1%) in the intervention group achieved adherence compared with none of patient in the control group (RR for adherence 71.5, 95% CI: 4.54 to 1126.80; p=0.002). SUA level was decreased significantly from baseline in both study groups, however, the reduction in the intervention group was significantly greater than in the control group (−1.47±0.86 vs −0.28±0.39 mg/dL, p<0.001). Serum creatinine was significantly decreased in the intervention group (−0.03±0.09 mg/dL, p<0.031), while serum creatinine was unchanged in the control group (0.01±0.08 mg/dL, p=0.84).

Conclusions Patients who received daily short message reminder had significantly improved adherence and reduction in SUA compared with the control individuals. Mobile phones text reminders may be an important tool to enhance allopurinol adherence and help in controlling SUA level in gout patients.

Disclosure of Interest None declared