Adherence to therapy in patients with gout


DOI: https://dx.doi.org/10.18565/therapy.2021.8.93-101

Shchemeleva E.V., Skorodumova E.A.

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine
Abstract. Despite the availability of effective urate-lowering medicaments, gout is often difficult to correct.
Aim of the study – to estimate the adherence to urate-lowering therapy (ULT) in gout patients examined at I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine.
Material and methods. From January to May 2021, a direct survey of 53 patients (49 males and 4 females) suffering from gout, aged 32–85 years (mean age 55,0±8,8 years) was performed. The duration of the disease varied from 1 to 23 years (average 9,1±5,2 years). The participants were asked questions about the age, duration of the disease, the number of gout attacks in the last 12 months, the frequency and last episode of examination by a rheumatologist, adherence to a hypouricemic diet, and the type and kind of receiving pharmacotherapy. 37 patients underwent uric acid level determination (UA).
Results. From the 53 examined, only 11,3% of patients had no gout attacks in the last 12 months, in the remaining 88,7% they persisted. Almost half of the patients did not follow the diet at all, 51,0% of the patients did it or tried to comply with periodic deviations. ULT was received by 51,0% of the studied patients. Allopurinol at the time of the survey was taken by 92,6%, most of whom used a dose of 100 mg/day (duration of admission from 2 months to 13 years). Only 3,8% of patients were treated with febuxostat by 80 mg/day dose. 49.0% of patients at the time of the study did not receive ULT. 13,2% from them had previously used allopurinol, but they canceled it on their own. About a third of the participants (30,2%) had never been examined by a rheumatologist before. Only one patient (1,9%) of the interviewed was regularly observed by this specialist. 67,9% of patients consulted a rheumatologist from time to time. At the same time, only 5 patients were examined by a rheumatologist during the last 12 months (13.9% of the group of periodically observed patients). In 69,8% of the respondents, the MC level was determined, and only 3 of them (8,1%) had a target level of this index <6,0 mg/dL.
Conclusion. Adherence to therapy among patients with gout is low, in most of the examined the MC level does not reach the target values (91,9%). One of the most important ways to increase adherence to therapy in gout patients is to increase their awareness of the disease and the principles of its treatment.
Keywords: xanthine oxidase inhibitors, urate-lowering therapy, adherence to therapy, gout, hyperuricemia
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About the Autors

Elena V. Schemeleva, PhD, researcher of the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192071, Saint Petersburg, 3 Budapeshtskaya Str. Tel.: +7 (921) 928-87-38. E-mail: schemeleva@yandex.ru
Elena A. Skorodumova, MD, leading researcher of the Department of emergency cardiology and rheumatology, I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Address: 192071, Saint Petersburg,
3 Budapeshtskaya Str. Tel.: +7 (921) 327-65-10. E-mail: elskor@mail.ru


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