Evaluation of treatment compliance in gout patients: a patient-centered study

Most studies on unsuccessful gout treatment suggest that knowledge gaps and inadequate physician interventions are major contributors. However, there is a lack of research on the extent to which patients, educated by knowledgeable and experienced physicians, adhere to these recommendations.

This study evaluated patients seen in university rheumatology clinics who were adequately informed about diet, target serum uric acid levels, and gout by rheumatologists. We assessed their compliance with treatment, clinical and laboratory findings, and disease status a median of seven years after treatment initiation. A total of 302 gout patients who began treatment in tertiary rheumatology centers and received adequate information were screened. After the initial interview, 195 patients met the study criteria and were included. Treatment compliance was evaluated based on self-reports, and target uric acid level achievement was assessed using medical records.

Of the 195 patients included in the study, 87.4% were male, with a median age of 59 years. Common comorbidities included hypertension (50%), hypertriglyceridemia (54.5%), and diabetes mellitus (23.2%). The median BMI was 29.3 kg/m², with 45.1% classified as overweight and 44.6% as obese. At the last follow-up, 68.5% of patients who continued their prescribed medication remained adherent. Nonadherent patients consumed significantly more meat (≥3.5 servings/week) and experienced longer intervals between flares. Nonadherent patients also had higher uric acid levels (7.25 mg/dL vs. 6.0 mg/dL, p < 0.001) and more frequent gout flares. Regular follow-up visits were significantly lower in nonadherent patients.

Achieving an acceptable level of treatment adherence and success in gout patients depends on adequate disease knowledge and appropriate education provided by physicians.