Medication adherence among patients with gout : A systematic review and meta-analysis
Copyright © 2018 Elsevier Inc. All rights reserved..
OBJECTIVE: In the management of chronic gout, a large proportion of patients need long-term management with urate lowering therapy (ULT). This study reviews medication adherence to ULT and summarizes factors associated with adherence.
METHODS: We performed a systematic literature search for studies on adherence to ULT among gout patients in PubMed, Embase, CINAHL, and PsycINFO. We conducted meta-analysis, with a random effect model, for the studies reporting the proportion of patients considered adherent to at least 80% of prescribed medication or time taken. We explored potential sources of heterogeneity, including geographic area and measure of adherence. Narrative summaries were made for data on adherence assessed/defined by Medication Event Monitoring System (MEMS)/pill-count or patient-reported, occurrence of a gap in therapy ≥30 days (non-persistence), and factors associated with adherence.
RESULTS: Of the 24 studies, 16 assessed adherence using prescription/claims data, two by the MEMS or pill count, and six by patient-reported data. The pooled proportion of adherent patients (n = 13) was 46% (95% CI: 41-51); 45% across studies conducted in the USA (n = 8) and 48% in other countries (n = 5). Adherence assessed by MEMS/pill count and patient-reported was much higher than by studies using prescription/claims data. Non-persistence (n = 6) ranged from 54% to 87%. Factors associated with adherence were investigated in 18 studies. Strong evidence for a positive association with older age, more comorbidities, and the presence of diabetes or hypertension was found.
CONCLUSION: Medication adherence to ULT among gout patients was poor. Better insight into reasons and consequences or poor adherence is needed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
Seminars in arthritis and rheumatism - 47(2018), 5 vom: 26. Apr., Seite 689-702 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Scheepers, Lieke E J M [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 14.11.2018 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.semarthrit.2017.09.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM278643019 |
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| 100 | 1 | |a Scheepers, Lieke E J M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Medication adherence among patients with gout |b A systematic review and meta-analysis |
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| 500 | |a Date Revised 02.12.2018 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2018 Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: In the management of chronic gout, a large proportion of patients need long-term management with urate lowering therapy (ULT). This study reviews medication adherence to ULT and summarizes factors associated with adherence | ||
| 520 | |a METHODS: We performed a systematic literature search for studies on adherence to ULT among gout patients in PubMed, Embase, CINAHL, and PsycINFO. We conducted meta-analysis, with a random effect model, for the studies reporting the proportion of patients considered adherent to at least 80% of prescribed medication or time taken. We explored potential sources of heterogeneity, including geographic area and measure of adherence. Narrative summaries were made for data on adherence assessed/defined by Medication Event Monitoring System (MEMS)/pill-count or patient-reported, occurrence of a gap in therapy ≥30 days (non-persistence), and factors associated with adherence | ||
| 520 | |a RESULTS: Of the 24 studies, 16 assessed adherence using prescription/claims data, two by the MEMS or pill count, and six by patient-reported data. The pooled proportion of adherent patients (n = 13) was 46% (95% CI: 41-51); 45% across studies conducted in the USA (n = 8) and 48% in other countries (n = 5). Adherence assessed by MEMS/pill count and patient-reported was much higher than by studies using prescription/claims data. Non-persistence (n = 6) ranged from 54% to 87%. Factors associated with adherence were investigated in 18 studies. Strong evidence for a positive association with older age, more comorbidities, and the presence of diabetes or hypertension was found | ||
| 520 | |a CONCLUSION: Medication adherence to ULT among gout patients was poor. Better insight into reasons and consequences or poor adherence is needed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Adherence | |
| 650 | 4 | |a Allopurinol | |
| 650 | 4 | |a Compliance | |
| 650 | 4 | |a Gout | |
| 650 | 4 | |a Medication behavior | |
| 650 | 4 | |a Persistence | |
| 650 | 4 | |a Systematic literature review | |
| 650 | 4 | |a Urate lowering therapy | |
| 650 | 4 | |a Uric acid | |
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| 650 | 7 | |a Allopurinol |2 NLM | |
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| 700 | 1 | |a Arts, Ilja C W |e verfasserin |4 aut | |
| 700 | 1 | |a Boonen, Annelies |e verfasserin |4 aut | |
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