Optimizing adherence to allopurinol for gout: patients' perspectives

Area of Science:

• Rheumatology
• Pharmacology
• Patient Adherence Research

Background:

• Gout management is often suboptimal due to poor adherence to allopurinol.
• Understanding patient perspectives on adherence is crucial for effective gout treatment.

Purpose of the Study:

• To identify facilitators and barriers to allopurinol adherence across medication adherence stages.
• To explore patient views on strategies for improving adherence, including self-monitoring urate levels.

Main Methods:

• Conducted semi-structured interviews with 26 individuals with gout on allopurinol.
• Thematic analysis of interview transcripts using inductive and deductive approaches.

Main Results:

• Adherence facilitators included motivation, trust in healthcare professionals (HCPs), belief in allopurinol's efficacy, and reminder systems.
• Barriers included reluctance to start long-term medication, forgetfulness, gout flares, and lack of feedback.
• Patients discontinued allopurinol if perceived as ineffective or unnecessary, often linked to flares and poor HCP advice.

Conclusions:

• Patient perceptions of allopurinol's necessity and effectiveness significantly impact adherence.
• Strategies involving patient education on urate control and accurate medical advice can enhance allopurinol adherence.