Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout

Authors: Jane C. Richardson, Jennifer Liddle, Christian D. Mallen, Edward Roddy, Samantha Hider, Suman Prinjha, Sue Ziebland

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Although international guidelines encourage urate lowering therapy (ULT) for people who have more than two attacks of gout, only 30 % of patients are prescribed it and only 40 % of those adhere to the treatment. The aim was to explore reasons for this through an exploration of patient experience and understanding of ULT treatment for gout.

Methods

A qualitative study was conducted throughout the United Kingdom. Narrative and semi-structured video-recorded interviews and thematic analysis were used.

Results

Participants talked about their views and experiences of treatment, and the factors that affected their use of ULT. The analysis revealed five main themes: 1) knowledge and understanding of gout and its treatment; 2) resistance to taking medication; 3) uncertainty about when to start ULT; 4) experiences of using ULT; and 5) desire for information and monitoring.

Conclusion

Patients’ understanding and experiences of gout and ULT are complex and it is important for clinicians to be aware of these when working with patients. It is also important for clinicians to know that patients’ perceptions and behaviour are not fixed, but can change over time, with changes to their condition, with dialogue and increased understanding. Patients want this interaction with their clinicians, through “a joint effort over a period of time”.
Literature
1.
Kuo C-F, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Ann Rheum Dis. 2014;0:1–7.
2.
Roddy E, Zhang W, Doherty M. The changing epidemiology of gout. Nat Clin Pract Rheumatol. 2007;3(8):443–9.CrossRefPubMed
3.
Zhang W, Doherty M, Pascual E, Bardin T, Barskova V, Conaghan P, EULAR Standing Committee for International Clinical Studies Including Therapeutics. EULAR evidence based recommendations for gout. Part I: diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65:1301–11.CrossRefPubMedPubMedCentral
4.
Jordan KM, Cameron JS, Snaith M, Zhang W, Doherty M, Seckl J, British Society for Rheumatology and British Health Professionals in Rheumatology Standards, Guidelines and Audit Working Group (SGAWG). British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatol (Oxford). 2007;46:1372–4.CrossRef
5.
Khanna D, Khanna PP, Fitzgerald JD, Singh MK, Mae S, Neogi T, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis. Arthritis Care Res. 2012;64(10):1447–61.CrossRef
6.
Zhang W, Doherty M, Bardin T, Pascual E, Barskova V, Conaghan P, et al. EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65:1312–24.CrossRefPubMedPubMedCentral
7.
Rees F, Jenkins W, Doherty M. Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann Rheum Dis. 2013;72:826–30.CrossRefPubMed
8.
9.
Roddy E, Zhang W, Doherty M. Concordance of the management of chronic gout in a UK primary-care population with the EULAR gout recommendations. Ann Rheum Dis. 2007;66:1311–5.CrossRefPubMedPubMedCentral
10.
Annemans L, Spaepen E, Gaskin M, Bonnemarie M, Malier V, Gilbert T, et al. Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000–2005. Ann Rheum Dis. 2008;67:960–6.CrossRefPubMed
11.
Cottrell E, Crabtree V, Edwards J, Roddy E. Improvement in the management of gout is vital and overdue: an audit from a UK primary care medical practice. BMC Family Practice. 2013;14:170.CrossRefPubMedPubMedCentral
12.
Mikuls TR, Farrar JT, Bilker WB, Fernandes S, Saag KG. Suboptimal physician adherence to quality indicators for the management of gout and asymptomatic hyperuricaemia: results from the UK General Practice Research Database (GPRD). Rheumatol (Oxford). 2005;44:1038–42.CrossRef
13.
Neogi T, Hunter DJ, Chaisson CE, Allensworth-Davies D, Zhang Y. Frequency and predictors of inappropriate management of recurrent gout attacks in a longitudinal study. J Rheumatol. 2006;33:104–9.PubMed
14.
Wall GC, Koenigsfeld CF, Hegge KA, Bottenberg MM. Adherence to treatment guidelines in two primary care populations with gout. Rheumatol Int. 2010;30:749–53.CrossRefPubMed
15.
Pal B, Foxall M, Dysart T, Carey F, Whittaker M. How is gout managed in primary care? A review of current practice and proposed guidelines. Clin Rheumatol. 2000;19:21–5.CrossRefPubMed
16.
Reaves E, Arroll B. Management of gout in a South Auckland general practice. J Prim Health Care. 2014;6(1):73–8.PubMed
17.
Harrold LR, Andrade SE, Briesacher B, Raebel MA, Fouayzi H, Yood RA, et al. The dynamics of chronic gout treatment: medication gaps and return to therapy. Am J Med. 2010;123(1):54–9.CrossRefPubMedPubMedCentral
18.
19.
Harrold LR, Mazor KM, Velten S, Ockene IS, Yood R. Patients and providers view gout differently: a qualitative study. Chronic Illness. 2010;6:263–71.CrossRefPubMedPubMedCentral
20.
Lipworth W, Kerridge I, Brett B, Day R. How clinical and research failures lead to suboptimal prescribing: the example of chronic gout. BMJ. 2011;343:d7459.CrossRefPubMed
21.
Harrold LR, Mazor KM, Peterson D, Naz N, Firneno C, Yood RA. Patients’ knowledge and beliefs concerning gout and its treatment: a population based study. BMC Musculoskeletal Disorders. 2012;13:180.CrossRefPubMedPubMedCentral
22.
Doherty M, Jansen TL, Nuki G, Pascual E, Perez-Ruiz F, Punzi L, et al. Gout: why is this curable disease so seldom cured? Ann Rheum Dis. 2012;71:1765–70.CrossRefPubMed
23.
Li Q-H, Dai L, Li Z-X, Liu H-J, Zou C-J, Ou-Yang X, et al. Questionnaire survey evaluating disease-related knowledge for 149 primary gout patients and 184 doctors in south China. Clin Rheumatol. 2013;32:1633–40.CrossRefPubMed
24.
25.
Spencer K, Carr A, Doherty M. Patient and provider barriers to effective management of gout in general practice: a qualitative study. Ann Rheum Dis. 2012;71:1490–5.CrossRefPubMed
26.
Singh JA. The impact of gout on patient’s lives: a study of African-American and Caucasian men and women with gout. Arthritis Res Ther. 2014;16(3):R132.CrossRefPubMedPubMedCentral
27.
Patton M. Qualitative evaluation and research methods. Beverly Hills: Sage; 1990.
28.
Mishler EG. Research interviewing: context and narrative. Harvard: Harvard University Press; 1991.
29.
Ziebland S, McPherson A. Making sense of qualitative data analysis: an introduction with illustrations from DIPEx (personal experiences of health and illness). Medical Education. 2006;40(5):405–14.CrossRefPubMed
30.
Pound P, Britten N, Morgan M, Yardley L, Pope C, Daker-White G, Campbell R. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med. 2005;61(1):133–55.CrossRefPubMed
31.
32.
Dalbeth N, Petrie KJ, House M, Chong J, Leung W, Chequdi R, McQueent FM, Taylor WJ. lllness perceptions in patients with gout and the relationship with progression of musculoskeletal disability. Arthritis Care & Research. 2011;63(11):1605–12.CrossRef
33.
Robinson PC, Schumacher HR. A qualitative and quantitative analysis of the characteristics of gout patient education resources. Clin Rheumatol. 2013;32:771–8.CrossRefPubMed
34.
McAdams MA, Maynard JW, Baer AN, Köttgen A, Clipp S, Coresh J, Gelber AC. Reliability and sensitivity of the self-report of physician-diagnosed gout in the campaign against cancer and heart disease and the atherosclerosis risk in the community cohorts. J Rheumatol. 2011;38(1):135–41.CrossRefPubMed
35.
Rees F, Hui M, Doherty M. Optimizing current treatment of gout. Nat Rev Rheumatol. 2014;10:271–83.CrossRefPubMed
Metadata
Title
A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout
Authors
Jane C. Richardson
Jennifer Liddle
Christian D. Mallen
Edward Roddy
Samantha Hider
Suman Prinjha
Sue Ziebland
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1117-5

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue

Research article

Computer-assisted total knee arthroplasty using mini midvastus or medial parapatellar approach technique

Study protocol

Cooperative pain education and self-management (COPES): study design and protocol of a randomized non-inferiority trial of an interactive voice response-based self-management intervention for chronic low back pain

Research article

Local pamidronate influences fracture healing in a rodent femur fracture model: an experimental study

Research article

Inpatient gradual diagnostics and its relevance for determining treatment strategies in lumbar back pain

Research article

Systematic data-querying of large pediatric biorepository identifies novel Ehlers-Danlos Syndrome variant

Research article

Comparison of percutaneous cannulated screw fixation and calcium sulfate cement grafting versus minimally invasive sinus tarsi approach and plate fixation for displaced intra-articular calcaneal fractures: a prospective randomized controlled trial