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Adherence to gout guidelines: where do we stand?

Gary H Ho^1,2, Michael H Pillinger^1,2, Michael Toprover^1,2

¹Department of Medicine, Division of Rheumatology, NYU Grossman School of Medicine.

Current Opinion in Rheumatology

|December 17, 2020

Summary

This summary is machine-generated.

Despite rising gout prevalence, treatment adherence remains low. Guideline-directed urate-lowering therapy, when protocolized, shows success in managing this common rheumatologic disease.

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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

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Published on: July 11, 2013

Area of Science:

Rheumatology
Internal Medicine
Public Health

Background:

Gout is a prevalent and increasingly common rheumatologic disease.
Despite extensive research, gout remains underappreciated and undertreated.
Suboptimal adherence to urate-lowering therapy (ULT) is a significant challenge in gout management.

Purpose of the Study:

To review the current state of gout treatment adherence.
To highlight the potential of guideline-directed therapy in improving outcomes.
To discuss strategies for enhancing adherence to urate-lowering therapy.

Main Methods:

Analysis of multinational meta-analyses on gout treatment adherence.
Review of studies evaluating patient and provider adherence.
Examination of healthcare disparities influencing adherence.
Case studies of successful protocolized treatment (RAmP-Up, Nottingham Gout Treatment trials).

Main Results:

Multinational data indicate persistently suboptimal adherence to gout treatments.
Existing methods for measuring adherence have limitations and may overestimate compliance.
Protocolized gout treatment strategies, as demonstrated in trials, can be highly successful.
Healthcare disparities are a critical factor to consider in adherence challenges.

Conclusions:

Standardized gout treatment protocols are essential for primary care and specialty practices.
Utilizing nonphysician providers for ULT titration and serum urate monitoring improves adherence.
Increased frequency of outpatient visits for patient education and direct care enhances treatment success.
Effective gout management requires addressing both patient and provider adherence through standardized protocols and targeted interventions.