Multilevel factors predicting medication adherence among gout patients in China: A 1‑year prospective cohort study

Adherence to urate-lowering therapy (ULT) is crucial for gout management, yet it remains suboptimal worldwide, particularly in China where relevant data are scarce. This study investigates the prevalence and predictors of medication adherence among Chinese gout patients receiving ULT over a 1-year period. A 1-year prospective cohort study was conducted among gout patients prescribed ULT at a single center. Adherence was assessed using the Compliance Questionnaire in Rheumatology at 6 and 12 months, with scores ≥80% defining adherence. Predictors encompassing socioeconomic, therapy-related, patient-related, condition-related, and healthcare system-related factors were analyzed using multiple linear regression models. Among 141 recruited patients (96.5% male), the adherence prevalence was 8.3% (11/133) at 6 months and 7.1% (9/127) at 1 year. In multiple linear regression, a higher gout knowledge (Gout Knowledge Questionnaire) score was independently associated with better adherence at 6 months (β = -0.223, P = .001). At 1 year, taking urate-lowering agent in the past week was the sole independent predictor (β = 0.178, P = .014). Medication adherence to ULT among gout patients in this Chinese cohort is notably low and declines over time. Patient knowledge and recent medication-taking behavior are key modifiable predictors. Interventions should be targeted within the first 6 months of therapy.