Overcoming adherence issues and other barriers to optimal care in gout

UMMS Affiliation

Department of Orthopedics and Physical Rehabilitation; Department of Medicine; School of Medicine; Meyers Primary Care Institute

Faculty Mentor

Leslie Harrold

Publication Date


Document Type



Health Services Administration | Health Services Research | Musculoskeletal Diseases | Rheumatology


PURPOSE OF REVIEW: This review presents research published over the last year examining use of urate-lowering therapy (ULT) as well as trends over time in adherence to this class of agents. Additionally, it explores factors associated with nonadherence to ULTs for chronic gout and interventions to improve chronic gout management.

RECENT FINDINGS: New literature suggests prescriptions of ULTs for prevalent and incident gout patients remains lower than expected based on the burden of the disease in the population. Overall ULT adherence remains suboptimal, in part related to inadequate patient education and copayment costs; although one study demonstrated improvement in adherence over a 15-year study period. Finally, interventions that include patient education and medication titration based on laboratory results successfully lowered serum urate levels to less than 6 mg/dl in the majority of patients.

SUMMARY: Gout remains a prevalent disease that is poorly managed despite effective treatments. Recent research suggests that ULTs are underutilized and even when prescribed are not well adhered to. Patient-centered interventions that focus on education about pharmacologic therapy and lifestyle modifications with medication titration have resulted in a greater proportion of patients achieving recommended serum urate levels.


gout, medication adherence, quality improvement, urate-lowering therapy

DOI of Published Version



Nasser-Ghodsi N, Harrold LR. Overcoming adherence issues and other barriers to optimal care in gout. Curr Opin Rheumatol. 2015 Mar;27(2):134-8. doi: 10.1097/BOR.0000000000000141. PubMed PMID: 25633242.

Journal/Book/Conference Title

Current opinion in rheumatology


Medical student Navine Nasser-Ghodsi participated in this study as part of the Senior Scholars research program at the University of Massachusetts Medical School.

Related Resources

Link to article in PubMed

PubMed ID