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A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout.
BMC Musculoskelet Disord. 2016 06 06; 17:249.BM

Abstract

BACKGROUND

Although international guidelines encourage urate lowering therapy (ULT) for people who have more than two attacks of gout, only 30 % of patients are prescribed it and only 40 % of those adhere to the treatment. The aim was to explore reasons for this through an exploration of patient experience and understanding of ULT treatment for gout.

METHODS

A qualitative study was conducted throughout the United Kingdom. Narrative and semi-structured video-recorded interviews and thematic analysis were used.

RESULTS

Participants talked about their views and experiences of treatment, and the factors that affected their use of ULT. The analysis revealed five main themes: 1) knowledge and understanding of gout and its treatment; 2) resistance to taking medication; 3) uncertainty about when to start ULT; 4) experiences of using ULT; and 5) desire for information and monitoring.

CONCLUSION

Patients' understanding and experiences of gout and ULT are complex and it is important for clinicians to be aware of these when working with patients. It is also important for clinicians to know that patients' perceptions and behaviour are not fixed, but can change over time, with changes to their condition, with dialogue and increased understanding. Patients want this interaction with their clinicians, through "a joint effort over a period of time".

Links

PMC Free PDF

Authors+Show Affiliations

Richardson JC
Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs., ST5 5BG, UK. j.c.richardson@keele.ac.uk.
Liddle J
Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs., ST5 5BG, UK.
Mallen CD
Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs., ST5 5BG, UK.
Roddy E
Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs., ST5 5BG, UK.
Hider S
Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffs., ST5 5BG, UK.
Prinjha S
Nuffield Department of Primary Care Health Sciences, University of Oxford, Gibson Building, 1st Floor, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Ziebland S
Nuffield Department of Primary Care Health Sciences, University of Oxford, Gibson Building, 1st Floor, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.

MeSH

AdultAgedAged, 80 and overAllopurinolCooperative BehaviorFemaleGoutGout SuppressantsHealth Knowledge, Attitudes, PracticeHumansLong-Term CareMaleMedication AdherenceMiddle AgedMotivationPhysician-Patient RelationsPractice Guidelines as TopicQualitative ResearchRheumatologistsUnited KingdomUric Acid

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27267878

Citation

Richardson, Jane C., et al. "A Joint Effort Over a Period of Time: Factors Affecting Use of Urate-lowering Therapy for Long-term Treatment of Gout." BMC Musculoskeletal Disorders, vol. 17, 2016, p. 249.
Richardson JC, Liddle J, Mallen CD, et al. A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout. BMC Musculoskelet Disord. 2016;17:249.
Richardson, J. C., Liddle, J., Mallen, C. D., Roddy, E., Hider, S., Prinjha, S., & Ziebland, S. (2016). A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout. BMC Musculoskeletal Disorders, 17, 249. https://doi.org/10.1186/s12891-016-1117-5
Richardson JC, et al. A Joint Effort Over a Period of Time: Factors Affecting Use of Urate-lowering Therapy for Long-term Treatment of Gout. BMC Musculoskelet Disord. 2016 06 6;17:249. PubMed PMID: 27267878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout. AU - Richardson,Jane C, AU - Liddle,Jennifer, AU - Mallen,Christian D, AU - Roddy,Edward, AU - Hider,Samantha, AU - Prinjha,Suman, AU - Ziebland,Sue, Y1 - 2016/06/06/ PY - 2016/01/03/received PY - 2016/06/02/accepted PY - 2016/6/9/entrez PY - 2016/6/9/pubmed PY - 2017/11/29/medline KW - Gout KW - Patient perceptions KW - Primary care KW - Qualitative KW - Urate lowering therapy (ULT) SP - 249 EP - 249 JF - BMC musculoskeletal disorders JO - BMC Musculoskelet Disord VL - 17 N2 - BACKGROUND: Although international guidelines encourage urate lowering therapy (ULT) for people who have more than two attacks of gout, only 30 % of patients are prescribed it and only 40 % of those adhere to the treatment. The aim was to explore reasons for this through an exploration of patient experience and understanding of ULT treatment for gout. METHODS: A qualitative study was conducted throughout the United Kingdom. Narrative and semi-structured video-recorded interviews and thematic analysis were used. RESULTS: Participants talked about their views and experiences of treatment, and the factors that affected their use of ULT. The analysis revealed five main themes: 1) knowledge and understanding of gout and its treatment; 2) resistance to taking medication; 3) uncertainty about when to start ULT; 4) experiences of using ULT; and 5) desire for information and monitoring. CONCLUSION: Patients' understanding and experiences of gout and ULT are complex and it is important for clinicians to be aware of these when working with patients. It is also important for clinicians to know that patients' perceptions and behaviour are not fixed, but can change over time, with changes to their condition, with dialogue and increased understanding. Patients want this interaction with their clinicians, through "a joint effort over a period of time". SN - 1471-2474 UR - https://www.unboundmedicine.com/medline/citation/27267878/A_joint_effort_over_a_period_of_time:_factors_affecting_use_of_urate_lowering_therapy_for_long_term_treatment_of_gout_ DB - PRIME DP - Unbound Medicine ER -