Assessment of therapy adherence and treatment results in gout patients who attended schools for patients and in those who did not

Background: Gout is a poorly controlled disease despite the availability of effective treatment methods. One of the main reasons for its poor controll is patients’ low adherence to treatment, including due to insufficient knowledge of treatment principles. Objectives: To assess adherence to therapy and results of treatment in gout patients who attended schools for patients and in those who did not. Methods: All patients with crystal-verified gout were interviewed and invited to attend School for gout pts. Totally 301 pts with gout were observed, 36 (10%) females and 264 (90%) males, mean age 54.5±12,7 y., mean disease duration 9.02±1,12 y., with the gout diagnosis verified at average 48.71[ months after the onset, the target UA level <360 µmol/l initially was in 72 pts (24%). All patients were divided into 3 groups: Group 1 included 111 (36%) patients who refused to attend the school, Group 2 included 90 (30%) patients who consented but failed to come, Group 3 consisted of 100 (34%) patients who attended the School (- 100 (34%)). The data from the questionnaires were used for baseline and on-treatment assessments of the following: patient‘s attitude to the disease, patient’s compliance to treatment, satisfaction with quality of life, the fact of taking urate-lowering therapy, UA level control, achievement of the UA level of <360 µmol/l. Results: In all 3 groups, after the visit to the doctor, the number of the patients taking urate-lowering therapy who reached the target level of uric acid, significantly increased, the maximum values were noted in the group who attended the School for gout pts. The UA target level achievement results in Group 2, of those who agreed to attend the School but never did for various reasons, were better than in Group 1 and comparable to that in Group 3. Table 1 presents the results of questionnaire survey at baseline and after one year. Better adherence to treatment was noted in patients with poorer quality of life and a rational attitude toward their disease. The patients who report satisfaction with quality of life often decided to refuse to take their medications, visited the doctor less often and more seldom achieved the UA target level. Abstract FRI0226 – Table 1 Parameters at baseline and after one year parameters Group 1 (patients who refused to attend the school), n=111 Group 2 (patients who consented but failed to come), n=90 Group 3 (patients who attended the school), n=100 baseline after 1 year baseline after 1 year baseline after 1 year Did not take urate lowering therapy, n (%) 86 (79%) 38 * (35%) 55 (62%) 12 (12%) 56 (56%) 8 (8%) Monitored the level of UA, n (%) 62 (56%) 76 * (69%) 68 (75%) 72 (80%) 62 (62%) 90 (92%) Achieved the target UA level<360 µmol/l, n (%) 8 (33%) 56* (51%) 14 (15%) 62 (69%) 13 (13%) 87 (87%) Satisfied with the quality of life, n (%) 84 (67%) 85 (77%) 42 (47%) 75 (83%) 62 (62%) 95 (95%) Not satisfied with the quality of life, n (%) 26 (33%) 5 (5%) 48 (53%) 3 (4%) 38 (38%) 3 (3%) »*<0,05 between the baseline and one-year Conclusions: Patients’ attendance of the School for gout pts increases their adherence to urate-lowering treatment and promote better quality of life. However, treatment adherence in gout patients largely depends on mental approach. Patients who are more actively involved in their health care achieve better results regardless of the source of information. Disclosure of Interest: None declared DOI: 10.1136/annrheumdis-2018-eular.6520 Citation: Ann Rheum Dis, volume 77, supplement Suppl, year 2018, page A654Session: Crystal diseases, metabolic bone diseases and bone diseases other than osteoporosis