کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2716975 1566202 2010 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The Dynamics of Chronic Gout Treatment: Medication Gaps and Return to Therapy
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
پیش نمایش صفحه اول مقاله
The Dynamics of Chronic Gout Treatment: Medication Gaps and Return to Therapy
چکیده انگلیسی

ObjectiveTo identify gaps in therapy with urate-lowering drugs for the treatment of gout as well as factors associated with resuming therapy.MethodsFrom 2 integrated delivery systems, we identified patients 18 years or older with a diagnosis of gout who initiated use of a urate-lowering drug from January 1, 2000 through June 30, 2006 and who had a gap in therapy. A gap was defined as a period of over 60 days after the completion of 1 prescription in which no refill for a urate-lowering drug was obtained. Survival curves were used to assess return to therapy of urate-lowering drugs. Cox proportional hazards analysis estimated the association between covariates and return to therapy.ResultsThere were 4166 new users of urate-lowering drugs (97% received allopurinol), of whom 2929 (70%) had a gap in therapy. Among those with a gap, in 75% it occurred in the first year of therapy. Fifty percent of patients with a gap returned to therapy within 8 months, and by 4 years it was 75%. Age 45-74 years (<45 referent) and greater duration of urate-lowering drug use before the gap was associated with resuming treatment within 1 year. In contrast, receipt of nonsteroidal anti-inflammatory drugs or glucocorticoids in the year before the gap was associated with a reduced likelihood of resuming therapy.ConclusionsThe majority of gout patients with gaps in urate-lowering drug use returned to treatment. More investigation is needed to better understand why patients may go for months without refilling prescriptions, given the clinical consequences of nonadherence.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The American Journal of Medicine - Volume 123, Issue 1, January 2010, Pages 54–59
نویسندگان
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