The Association between Medication Adherence, Belief about Medicine, and Other Factors among Patients with Gout in a Tertiary Hospital in Bangkok
Ratanapha Phuan-udom, MD1, Manathip Osiri, MD2
Affiliation : 1Division of Rheumatology, Department of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand, 2Division of Rheumatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Objective: Medication adherence is essential for the effective treatment of gout, as the primary goal is to maintain serum uric acid levels below 6 mg/dL. Various factors, including clinical, psychological, and socioeconomic factors, can influence patients’ adherence to treatment and subsequently affect gout control. The present study aimed to assess the relationship between medication beliefs and adherence to uric acid-lowering therapy in patients with gout and explore the associated factors.
Materials and Methods: In this cross-sectional study, patients with gout aged 20 to 80 years receiving urate-lowering therapy at a tertiary
hospital were enrolled. Medical adherence was assessed using the 8-item Morisky Medication Adherence Scale. Data on the Beliefs about Medicines Questionnaire (BMQ), demographics, socioeconomic, and clinical information were collected. The correlation between BMQ and adherence scores was assessed, and the risk factors for nonadherence were analyzed.
Results: Among the 302 participants, 87 (28.8%) were nonadherent. Adherence and BMQ scores exhibited a negatively weak correlation. The following were significant predictors of nonadherence: age less than 60 years (odds ratio (OR) 1.85 95% confidence interval (CI) 1.05 to 3.24; p=0.032), serum uric acid level (OR 1.29 95% CI 1.09 to 1.53; p=0.004), treatment duration of less than one year (OR 3.59 95% CI 1.28 to 10.09; p=0.015), and BMQ score (OR 1.04 95% CI 1.02 to 1.07; p=0.001). Meanwhile, comorbidities were classified as a negative predictor (OR 0.82 95% CI 0.69 to 0.97; p=0.022).
Conclusion: Strong medication beliefs influence medication adherence among patients with gout. If patients, particularly those under 60 years of age, newly diagnosed, or with few comorbidities, fail to achieve their target serum uric acid levels, it is crucial to explore their medication adherence, including their beliefs about the treatment.
Received 29 May 2024 | Revised 15 July 2024 | Accepted 16 July 2024
Keywords : Gout; Medication adherence; Belief about medicine; Urate-lowering therapy
