A Survey Of Treatment Adherence To Urate-lowering Therapy In Chinese Gout Patients And Its Influencing Factors

Objective The aim of this study was to explore Chinese gout patients' adherence rate and investigate potential risk factors for medication non-adherence,so as to provide the theoretical basis for clinical nursing intervention to improve patients' medication adherence.Methods Outpatients and inpatients with gout in the Affiliated Hospital of Nantong University were consecutively recruited.Patients were asked to complete a standardized self-report questionnaires: CQR,PHQ-9,GAD-7,GKQ,HAQ-DI,SF-36,VAS and confidence in gout treatment.Univariate analysis and regression analysis were used to explore the influencing factors of adherence to ULT.Results In this survey,149 questionnaires were given and 141 valid questionnaires were collected and analyzed.Based on CQR,the proportion of participants adhered to ULT was only 9.2%,patients' non-adherence rate was as high as 90.8%.54.6% of gout patients took allopurinol as ULT,the ratio of febuxostat was 51.1%.36.2% of the patients took more than 3 drugs.The results of univariate analysis showed that yearly per capita income(P=0.036),the number of exercise per week(P=0.022),HAQ-DI(P=0.028),whether to know about gout related knowledge(P<0.001),whether to know a painful swollen joint indicates gout flare(P=0.013),whether to know it is crystal inside the joint that causes attacks of gout(P=0.019),confidence to keep serum urate under control(P=0.003),confidence to have blood tests atrecommended frequency(P=0.002),and confidence to take ULT regularly(P<0.001)were associated with treatment adherence to ULT in gout patients.The life quality of patients with medication non-adherence was lower than that of adherence.The differences were observed in BP and MH of SF-36(P<0.05),while no statistic discrepancy was observed in other 6 dimensions of SF-36 between non-adherent and adherent patients(P?0.05).Stepwise Logistic regression analysis showed that no exercise per week(OR=60.567,95% CI [2.136,1717.315];P=0.016),unaware of a painful swollen joint indicates gout flare(OR=0.037,95%CI [0.003,0.463];P=0.011),and low confidence to take ULT regularly(OR=0.150,95% CI [0.032,0.701];P=0.016)were the main risk factors for medication non-adherence in patients with gout.Conclusions 90.8% of our investigated gout patients did not adhered to ULT.Yearly per capita income,the number of exercise per week,functional capacity,whether to know about gout related knowledge were related to medication adherence in patients with gout.No exercise per week,unawareness of a painful swollen joint indicates gout flare,and low confidence to take ULT regularly were predictors of medication non-adherence in gout patients.