Harrold, Leslie RAndrade, Susan E.Briesacher, Becky A.Raebel, Marsha A.Fouayzi, HassanYood, Robert A.Ockene, Ira S.2022-08-232022-08-232010-01-282010-04-30<p>Am J Med. 2010 Jan;123(1):54-9. <a href="http://dx.doi.org/10.1016/j.amjmed.2009.05.026">Link to article on publisher's site</a></p>0002-9343 (Linking)10.1016/j.amjmed.2009.05.02620102992https://hdl.handle.net/20.500.14038/36853OBJECTIVE: To identify gaps in therapy with urate-lowering drugs for the treatment of gout as well as factors associated with resuming therapy. METHODS: From 2 integrated delivery systems, we identified patients 18 years or older with a diagnosis of gout who initiated use of a urate-lowering drug from January 1, 2000 through June 30, 2006 and who had a gap in therapy. A gap was defined as a period of over 60 days after the completion of 1 prescription in which no refill for a urate-lowering drug was obtained. Survival curves were used to assess return to therapy of urate-lowering drugs. Cox proportional hazards analysis estimated the association between covariates and return to therapy. RESULTS: There were 4166 new users of urate-lowering drugs (97% received allopurinol), of whom 2929 (70%) had a gap in therapy. Among those with a gap, in 75% it occurred in the first year of therapy. Fifty percent of patients with a gap returned to therapy within 8 months, and by 4 years it was 75%. Age 45-74 years (<45 >referent) and greater duration of urate-lowering drug use before the gap was associated with resuming treatment within 1 year. In contrast, receipt of nonsteroidal anti-inflammatory drugs or glucocorticoids in the year before the gap was associated with a reduced likelihood of resuming therapy. CONCLUSIONS: The majority of gout patients with gaps in urate-lowering drug use returned to treatment. More investigation is needed to better understand why patients may go for months without refilling prescriptions, given the clinical consequences of nonadherence.en-USAge FactorsAgedAllopurinolAnti-Inflammatory Agents, Non-SteroidalChi-Square DistributionChronic DiseaseCohort StudiesColchicineDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesGlucocorticoidsGoutGout SuppressantsHumansKaplan-Meiers EstimateMaleMiddle AgedPatient ComplianceProbabilityProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSex FactorsTime FactorsTreatment OutcomeUric AcidCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesHealth Services ResearchMedicine and Health SciencesMusculoskeletal DiseasesNutritional and Metabolic DiseasesTherapeuticsJournal Articlehttps://escholarship.umassmed.edu/meyers_pp/2281293962meyers_pp/228