Gout patients endorse reasons for not taking allopurinol

Patients with gout who refuse to take allopurinol for their condition do so because of their desire to lead a normal life and to test whether they could reduce the dose without experiencing any symptoms, a recent study has found.

In this study, 69 men with gout attending rheumatology clinics and prescribed allopurinol for at least 6 months completed the Intentional Non-Adherence Scale (INAS). The investigators analysed differences in the types of intentional nonadherence between those who did and did not achieve serum urate (SU) at treatment target (<0.36 mmol/L, 6 mg/dL).

The most common reasons for patients not taking their urate-lowering therapy (ULT) were the desire to lead a normal life (23 percent) or thinking that they were a healthy person again (20 person). Some also reported not taking allopurinol to test whether they really needed it (22 percent).

Participants with SU above target reported more INAS items as reasons for not taking their medication, experienced more medicine-related concerns, and had a higher chance of endorsing “testing treatment” as a reason for nonadherence. Additionally, patients who were younger, single, non-New Zealand European had more reasons for not taking their medication.

“These results provide some potentially modifiable targets for adherence interventions and some recommendations to clinicians about how to reframe ULT for patients in order to improve adherence,” the investigators said.