Adherence with urate-lowering therapies for the treatment of gout.
Adherence with urate-lowering therapies for the treatment of gout.
复制标题
DOI：
10.1186/ar2659
复制
发表时间：
2009
影响因子：
4.9
通讯作者：
Ockene IS
中科院分区：
文献类型：
--
作者：
Harrold LR;Andrade SE;Briesacher BA;Raebel MA;Fouayzi H;Yood RA;Ockene IS
痛风患者对降尿酸药物（ULDs）的依从性尚未得到很好的评价。我们的目的是评估不遵守痛风规定的ld的水平和决定因素。我们确定了在2000年1月1日至2006年6月30日期间开始使用别嘌呤醇、probenecid或磺胺吡嗪的18岁或以上的痛风患者，他们使用两种综合给药系统。使用治疗第一年的药物占有比（MPR）测量非依从性，并将MPR < 0.8定义为MPR。计算描述性统计数据，并使用逻辑回归来估计患者特征与不依从性之间的关联强度。共有4166名痛风患者启动了ULDs；97%接受别嘌呤醇治疗。任何ULD使用的MPR中位数为0.68（四分位间距（IQR） 0.64）。超过一半的患者（56%）为非依从性（MPR < 0.8）。可怜的依从性的调整分析,预测因子包括年轻的年龄(比值比(或)2.43,95%可信区间(CI) 1.86到3.18的年龄< 45或1.44,95%可信区间1.08到1.93年龄45 - 49),更少的并存状况(或1.46,95%可信区间1.20到1.77),没有提供访问urate-lowering之前痛风药物启动(或1.28,95%可信区间1.05到1.55),和使用非甾体抗炎药在今年之前urate-lowering药物启动(或1.15,95%可信区间1.00到1.31)。在痛风患者中，不依从性是非常普遍的，特别是在年轻的患者中，合病较少，在痛风患者开始前没有就诊。供应商应该意识到不遵守ULDs的严重程度。
Adherence to urate-lowering drugs (ULDs) has not been well evaluated among those with gout. Our aim was to assess the level and determinants of non-adherence with ULDs prescribed for gout. We identified persons using two integrated delivery systems aged 18 years or older with a diagnosis of gout who initiated use of allopurinol, probenecid or sulfinpyrazone from 1 January 2000 to 30 June 2006. Non-adherence was measured using the medication possession ratio (MPR) over the first year of therapy and defined as an MPR < 0.8. Descriptive statistics were calculated and logistic regression was used to estimate the strength of the association between patient characteristics and non-adherence. A total of 4,166 gout patients initiated ULDs; 97% received allopurinol. Median MPR for any ULD use was 0.68 (interquartile range (IQR) 0.64). Over half of the patients (56%) were non-adherent (MPR < 0.8). In adjusted analyses, predictors of poor adherence included younger age (odds ratio (OR) 2.43, 95% confidence interval (CI) 1.86 to 3.18 for ages <45 and OR 1.44, 95% CI 1.08 to 1.93 for ages 45 to 49), fewer comorbid conditions (OR 1.46, 95% CI 1.20 to 1.77), no provider visits for gout prior to urate-lowering drug initiation (OR 1.28, 95% CI 1.05 to 1.55), and use of non-steroidal anti-inflammatory drugs in the year prior to urate-lowering drug initiation (OR 1.15, 95% CI 1.00 to 1.31). Non-adherence amongst gout patients initiating ULDs is exceedingly common, particularly in younger patients with less comorbidity and no provider visits for gout prior to ULD initiation. Providers should be aware of the magnitude of non-adherence with ULDs.
登录
查看更多内容
DOI：
10.1002/art.20405
发表时间：
2004-06-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Shoji, A;Yamanaka, H;Kamatani, N
通讯作者：
Kamatani, N
影响因子：
19.6
作者：
Kramer, HJ;Choi, HK;Curhan, GC
通讯作者：
Curhan, GC
影响因子：
27.4
作者：
Solomon, D. H.;Avorn, J.;Brookhart, M. A.
通讯作者：
Brookhart, M. A.
影响因子：
2.6
作者：
Andrade, Susan E.;Kahler, Kristijan H.;Chan, K. Arnold
通讯作者：
Chan, K. Arnold
DOI：
10.1093/jncimonographs/lgi032
发表时间：
2005-01-01
期刊：
Journal of the National Cancer Institute. Monographs
影响因子：
--
作者：
Wagner, Edward H;Greene, Sarah M;Vogt, Thomas M
通讯作者：
Vogt, Thomas M