{"id":19785,"date":"2024-06-03T16:48:02","date_gmt":"2024-06-03T20:48:02","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=19785"},"modified":"2024-06-17T16:49:42","modified_gmt":"2024-06-17T20:49:42","slug":"adherence-and-treat-to-target-benchmarks-in-older-adults-with-gout-initiating-urate-lowering-therapy-in-ontario-canada","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/adherence-and-treat-to-target-benchmarks-in-older-adults-with-gout-initiating-urate-lowering-therapy-in-ontario-canada\/","title":{"rendered":"Adherence and treat to target benchmarks in older adults with gout initiating urate lowering therapy in Ontario, Canada: a population-based study"},"content":{"rendered":"

Objectives<\/strong> \u2014 We sought to evaluate urate lowering therapy (ULT) adherence and treatment-to-target (T2T) serum uric acid (SUA) levels amongst older adults with gout starting ULT.<\/p>\n

Methods<\/strong> \u2014 We performed a population-based retrospective cohort study in Ontario, Canada in patients with gout aged \u226566 years newly dispensed ULT between 2010 and 2019. We defined successful T2T as patients having SUA levels <360 \u03bcmol\/L (6 mg\/dL) within 12-months after ULT dispensation. We also assessed adherence to ULT. Multi-level logistic regression clustered by ULT prescriber evaluated patient, physician and prescription factors associated with reaching target SUA levels.<\/p>\n

Results<\/strong> \u2014 Among 44,438 patients (mean (SD) age 76.0\u00b17.3 years; 64.4% male), 30,057 (67.6%) patients had \u22651 SUA test completed. Overall, 52.3% patients reached SUA target within 12-months, improving from 45.2% in 2010 to 61.2% in 2019 (p < 0.0001). ULT adherence was 55.3% overall and improved annually. Key factors associated with achieving T2T included febuxostat use (OR 11.40, 95% CI 5.10-25.43) (was only dispensed in 88 patients), ULT adherence (OR 5.17, 95% CI 4.89-5.47) allopurinol starting doses >50 mg (OR 2.53, 95% CI: 2.14-2.99), colchicine\/oral corticosteroids co-prescription (OR 1.24, 95% CI: 1.14-1.34) and ULT prescription from a rheumatologist.<\/p>\n

Conclusions<\/strong> \u2014 Only 52.3% of patients achieved an optimal SUA level within 1 year of ULT initiation. ULT adherence was suboptimal though improving over time. ULT adherence and higher allopurinol starting doses had the strongest associations of achieving a target SUA level. This study highlights room for improvement in gout management and potential strategies to address care gaps.<\/p>\n","protected":false},"excerpt":{"rendered":"

Objectives \u2014 We sought to evaluate urate lowering therapy (ULT) adherence and treatment-to-target (T2T) serum uric acid (SUA) levels amongst older adults with gout starting ULT. Methods \u2014 We performed a population-based retrospective cohort study in Ontario, Canada in patients with gout aged \u226566 years newly dispensed ULT between 2010 and 2019. We defined successful […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[46,17,56],"migration-helper-qa-sample-set":[],"class_list":["post-19785","journal_article","type-journal_article","status-publish","hentry","topic-internal-medicine","topic-older-people","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Kwok TSH, Kuriya B, Hawker G, Eder L, Li P, Choy G, Widdifield J. Arthritis Care Res<\/em>. 2024; Jun 3 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1002\/acr.25380","ices_scientist":[1267,1122],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Adherence and treat to target benchmarks in older adults with gout initiating urate lowering therapy in Ontario, Canada: a population-based study<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 We sought to evaluate urate lowering therapy (ULT) adherence and treatment-to-target (T2T) serum uric acid (SUA) levels amongst older adults\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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