Tags

Type your tag names separated by a space and hit enter

Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study.
Arthritis Res Ther. 2014 Mar 29; 16(2):R82.AR

Abstract

INTRODUCTION

Limited literature exists for qualitative studies of medication adherence in gout, especially in African-Americans. The aim of this study was to examine the facilitators and barriers to adherence to urate-lowering therapy (ULT) in African-Americans with gout.

METHODS

In this study, nine nominal groups lasting 1 to 1.5 hours each were conducted in African-Americans with gout, six with low ULT and three with high ULT adherence (medication possession ratios of <0.80 or ≥0.80, respectively). Patients presented, discussed, combined and rank ordered their concerns. A qualitative analysis was performed.

RESULTS

This study included 43 patients with mean age 63.9 years (standard deviation, 9.9), 67% men, who participated in nine nominal groups (seven in men, two in women): African-American men (n = 30); African-American women (n = 13). The main facilitators to ULT adherence (three groups) were the recognition of the need to take ULT regularly to prevent gout flares, prevent pain from becoming chronic/severe and to have less dietary restriction; the lack of side effects from ULT; trust in physicians; and avoiding the need to seek emergent/urgent care for flares. Patients achieved high ULT adherence by organizing their pills using the pillbox and the incorporation of ULT intake into their routine to prevent forgetting. The main barriers to optimal ULT adherence were (six groups): doubts about effectiveness of ULT, concerns about cost and side effects, concomitant medications, forgetfulness, refilling the prescriptions on time, pill size and difficulty in swallowing, competing priorities, patient preference for alternative medicines (that is, cherry juice) and frequent travel.

CONCLUSIONS

Identification of facilitators and barriers to high ULT adherence in African-Americans with gout in this study lays the foundation for designing interventions to improve ULT adherence in racial minorities.

Links

PMC Free PDF

Authors

Singh JA
No affiliation info available

MeSH

Black or African AmericanAgedAllopurinolEvaluation Studies as TopicFebuxostatFemaleFocus GroupsGoutGout SuppressantsHealth Knowledge, Attitudes, PracticeHumansMaleMedication AdherenceMiddle AgedThiazolesUric Acid

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

24678765

Clinical Trial Links

B/F/TAF Ease of Swallowability Trial

Citation

Singh, Jasvinder A.. "Facilitators and Barriers to Adherence to Urate-lowering Therapy in African-Americans With Gout: a Qualitative Study." Arthritis Research & Therapy, vol. 16, no. 2, 2014, pp. R82.
Singh JA. Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study. Arthritis Res Ther. 2014;16(2):R82.
Singh, J. A. (2014). Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study. Arthritis Research & Therapy, 16(2), R82. https://doi.org/10.1186/ar4524
Singh JA. Facilitators and Barriers to Adherence to Urate-lowering Therapy in African-Americans With Gout: a Qualitative Study. Arthritis Res Ther. 2014 Mar 29;16(2):R82. PubMed PMID: 24678765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study. A1 - Singh,Jasvinder A, Y1 - 2014/03/29/ PY - 2013/10/31/received PY - 2014/03/17/accepted PY - 2014/4/1/entrez PY - 2014/4/1/pubmed PY - 2015/9/2/medline SP - R82 EP - R82 JF - Arthritis research & therapy JO - Arthritis Res Ther VL - 16 IS - 2 N2 - INTRODUCTION: Limited literature exists for qualitative studies of medication adherence in gout, especially in African-Americans. The aim of this study was to examine the facilitators and barriers to adherence to urate-lowering therapy (ULT) in African-Americans with gout. METHODS: In this study, nine nominal groups lasting 1 to 1.5 hours each were conducted in African-Americans with gout, six with low ULT and three with high ULT adherence (medication possession ratios of <0.80 or ≥0.80, respectively). Patients presented, discussed, combined and rank ordered their concerns. A qualitative analysis was performed. RESULTS: This study included 43 patients with mean age 63.9 years (standard deviation, 9.9), 67% men, who participated in nine nominal groups (seven in men, two in women): African-American men (n = 30); African-American women (n = 13). The main facilitators to ULT adherence (three groups) were the recognition of the need to take ULT regularly to prevent gout flares, prevent pain from becoming chronic/severe and to have less dietary restriction; the lack of side effects from ULT; trust in physicians; and avoiding the need to seek emergent/urgent care for flares. Patients achieved high ULT adherence by organizing their pills using the pillbox and the incorporation of ULT intake into their routine to prevent forgetting. The main barriers to optimal ULT adherence were (six groups): doubts about effectiveness of ULT, concerns about cost and side effects, concomitant medications, forgetfulness, refilling the prescriptions on time, pill size and difficulty in swallowing, competing priorities, patient preference for alternative medicines (that is, cherry juice) and frequent travel. CONCLUSIONS: Identification of facilitators and barriers to high ULT adherence in African-Americans with gout in this study lays the foundation for designing interventions to improve ULT adherence in racial minorities. SN - 1478-6362 UR - https://www.unboundmedicine.com/medline/citation/24678765/Facilitators_and_barriers_to_adherence_to_urate_lowering_therapy_in_African_Americans_with_gout:_a_qualitative_study_ DB - PRIME DP - Unbound Medicine ER -