Urate-lowering therapy adherence and the association with medication beliefs, self-efficacy, depression, anxiety, and COVID-19 pandemic-related concern in Chinese gout patients

ABSTRACT

Background: Under the current situation of COVID-19 pandemic, more medical resources are assigned to the prevention and control of the pandemic, while relatively less attention is paid to patients with chronic diseases. Previous studies reported that COVID-19 deaths were mainly observed among male patients with multiple comorbidities, and the major comorbidities were hypertension, diabetes, coronary heart disease, cerebral infarction, and chronic bronchitis, all of which are chronic diseases. As one of the most common chronic diseases that occurs in male, no report regarding how COVID-19 impacts gout patients psychologically due to the general susceptibility, their mental state and willingness to adhere to ULT treatment and the actual ULT adherence so far. This study aims to assess urate-lowering therapy adherence and the relationship with medication beliefs, self-efficacy, depression, anxiety, and COVID-19 pandemic-related concern in Chinese gout patients during the COVID-19 outbreak. Method(s) The cross-sectional study employed a total of 101 gout patients receiving urate-lowering therapy to evaluate adherence, medication beliefs, self-efficacy, depression, anxiety, and COVID-19 pandemic-related concern via a mobile app-based questionnaire. Statistical analysis was performed using SPSS 22.0. Result(s) 101 valid responses were included in the statistical analysis. Patients' adherence rate to urate-lowering therapy during the COVID-19 outbreak was 22.8%, higher than that in normal periods (9.6%). Compared with adherent groups, non-adherent gout patients had shorter disease duration, lower self-efficacy, lower Necessity about urate-lowering therapy score, higher Concerns about urate-lowering therapy score, and smaller Necessity-Concerns differential. Depression and anxiety rates (3.0% and 5.0%, respectively) during the COVID-19 break were lower than that in normal periods. Additionally, depression, anxiety, as well as COVID-19 pandemic-related concern (27.7%) were not related to ULT adherence. Conclusion(s) Adherence rate to urate-lowering therapy in Chinese gout patients during the COVID-19 outbreak was 13.2%, higher than normal times, but still very poor. Except for a little concern about being more susceptible to the virus, patients' mental state is relatively good. While the country puts great efforts in COVID-19 prevention and control, attention must also be paid to the medication management of patients with chronic diseases such as gout.