Factors influencing medication adherence in patients with gout: A descriptive correlational study

Chua, Xin Hui; Lim, Siriwan; Lim, Fui Ping; Lim, Yee Nah Anita; He, Hong; Teng, Gim Gee

doi:10.1111/jocn.13918

Cited by 17 publications

(20 citation statements)

References 45 publications

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“…Other significant predictors of non‐adherence among Singaporeans with gout include presence of comorbidities, patient marital status, and education level . Consistent with the published literature on gout, local patients with comorbidities tend to be more adherent .…”

Section: Introductionsupporting

confidence: 68%

“…At the same time, allopurinol's therapeutic effect is not immediate. Patients take a few months to feel its full benefits and may experience increased frequency of gout attacks when the drug is 1st initiated, delaying evidence of its effectiveness …”

Section: Discussionmentioning

confidence: 99%

“…In Singapore's context, patient knowledge, beliefs, and attitudes toward ULT often predict non‐adherence . Traditionally, gout has been trivialized as a disease that does not impact mortality and morbidity . Many view gout as episodic and mistakenly discontinue ULT after symptomatic treatment .…”

Section: Introductionmentioning

confidence: 99%

“…Many view gout as episodic and mistakenly discontinue ULT after symptomatic treatment . Perceived or experienced adverse effects also deter patients and prescribers, especially as ULT can trigger acute flares when first initiated . Additionally, poor self‐conviction in being able to successfully execute adherent behavior (ie low self‐efficacy) has been linked to non‐adherence …”

Section: Introductionmentioning

confidence: 99%

“…Comorbidities also signal more life‐threatening conditions that realign patient attitudes toward adherence . Married individuals are also more likely adherent because of practical support from spouses in taking medication . Notably, gout patients with formal education in Singapore are found to be less adherent and possibly more critical of advice from their doctors …”

Section: Introductionmentioning

confidence: 99%

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Cost‐effectiveness of an adherence‐enhancing intervention for gout based on real‐world data

et al. 2018

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Aim Medication non‐adherence influences outcomes of therapies for chronic diseases. Allopurinol is a cornerstone therapy for patients with gout; however, non‐adherence to allopurinol is prevalent in Singapore and limits its effectiveness. Between 2008‐2010, an adherence‐enhancing program was implemented at the rheumatology division of a public tertiary hospital. The cost‐effectiveness of this program has not been fully evaluated. With healthcare resources being finite, the value of investing in adherence‐enhancing interventions should be ascertained. This study aims to evaluate the cost‐effectiveness of this adherence‐enhancing program to inform optimal resource allocation toward better gout management. Method Adopting a real‐world data approach, we utilized patient clinical and financial records generated in their course of routine care. Intervention and control groups were identified in a standing database and matched on nine risk factors through propensity score matching. Cost and effect data were followed through 1‐2 years. A decision tree was developed in TreeAge using a societal perspective. Deterministic and probabilistic sensitivity analyses were performed to assess parameter uncertainty. Results At an assumed willingness‐to‐pay threshold of $50 000 USD ($70 000 SGD) per quality‐adjusted life year (QALY), the intervention had an 85% probability of being cost‐effective compared to routine care. The incremental cost‐effectiveness ratio was $12 866 USD per QALY for the base case and ranged from $4 139 to $21 593 USD per QALY in sensitivity analyses. Conclusion The intervention is cost‐effective in the short‐term, although its long‐term cost‐effectiveness remains to be evaluated.

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Section: Introductionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%