title: Long-term persistence and adherence on urate-lowering treatment can be maintained in primary care-5-year follow-up of a proof-of-concept study.
abstract: To evaluate the persistence and adherence on urate-lowering treatment (ULT) in primary care 5 years after an initial nurse-led treatment of gout.
  
  
  
  One hundred gout patients initiated on up-titrated ULT between March and July 2010 were sent a questionnaire that elicited information on current ULT, reasons for discontinuation of ULT if applicable, medication adherence and generic and disease-specific quality-of-life measures in 2015. They were invited for one visit at which height and weight were measured and blood was collected for serum uric acid measurement.
  
  
  
  Seventy-five patients, mean age 68.13 years ( s . d . 10.07) and disease duration 19.44 years ( s . d . 13), returned completed questionnaires. The 5-year persistence on ULT was 90.7% (95% CI 81.4, 91.6) and 85.3% of responders self-reported taking ULT ⩾6 days/week. Of the 65 patients who attended the study visit, the mean serum uric acid was 292.8 μmol/l ( s . d . 97.2).
  
  
  
  An initial treatment that includes individualized patient education and involvement in treatment decisions results in excellent adherence and persistence on ULT >4 years after the responsibility of treatment is taken over by the patient's general practitioner, suggesting that this model of gout management should be widely adopted.
authors.affiliation: Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Abhishek
authors.affiliation: Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital.
authors.forename: Wendy
authors.initials: W
authors.lastname: Jenkins
authors.affiliation: Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital.|Department of Medicine, Nottingham University Hospitals NHS Trust.
authors.forename: Jonathan
authors.initials: J
authors.lastname: La-Crette
authors.affiliation: Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital.|Arthritis Research UK Centre for Sports, Exercise and Osteoarthritis, University of Nottingham, Nottingham, UK.
authors.forename: Gwen
authors.initials: G
authors.lastname: Fernandes
authors.affiliation: Academic Rheumatology, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital.
authors.forename: Michael
authors.initials: M
authors.lastname: Doherty
mesh_terms: D017668:Age of Onset; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006073:Gout / Q000188:drug therapy* / Q000451:nursing; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D016896:Treatment Outcome
chemical_list: D006074:Gout Suppressants
keywords: adherence; gout; persistence; urate lowering treatment