ABSTRACT
AIMS AND OBJECTIVES: To examine the factors influencing adherence to urate-lowering therapy in patients with gout in Singapore. BACKGROUND: Gout is the most common type of chronic inflammatory arthritis. Urate-lowering therapy is used to treat gout by reducing serum uric acid levels. However, adherence to urate-lowering therapy among patients remains poor. To date, there have been no available studies based on a conceptual framework that examined factors influencing medication adherence in patients with gout. DESIGN: Cross-sectional, descriptive correlational study. METHODS: A convenience sample of outpatients (n = 108) was recruited between October 2014-January 2015 from a tertiary hospital in Singapore. Outcomes were measured by relevant valid and reliable instruments. Descriptive statistics and parametric tests including multiple linear regression were used to analyse the data. RESULTS: Although 44.4% of the participants were high adherers to urate-lowering therapy, the mean adherence level was moderate. Significant differences in medication adherence scores were found among the subgroups of gender, ethnicity, marital status, employment status and presence of comorbidity. Medication adherence was positively significantly correlated with age, number of comorbidities and beliefs about medicines. Linear regression showed that higher level of beliefs about medicines, presence of comorbidity and being married were factors positively influencing medication adherence. CONCLUSIONS: This study revealed moderate adherence to urate-lowering therapy in patients with gout in Singapore, indicating the need for strategies to improve adherence by considering its main influencing factors. Future research should be conducted to develop interventions targeted at modifying patients' beliefs about medicines in order to improve medication adherence. RELEVANCE TO CLINICAL PRACTICE: Findings from this study allow healthcare providers to quickly and easily identify patients who may have low adherence. Nurses should take the lead in educating patients on the mechanism of urate-lowering therapy and highlight the importance of adhering to it.
