Pharmacist-Led Medication Adherence Intervention Improves Gout Outcomes
A pharmacist-led intervention incorporating automated telephone technology improved adherence and serum urate goal achievement in patients with gout.
Incorporating a pharmacist-led automated telephone intervention into clinical practice improved medication adherence and clinical outcomes in patients with gout, according to results from a study published in the American Journal of Medicine.
Researchers conducted a single-site, randomized study of 1463 patients with gout who were given either a pharmacist-led adherence intervention or standard care over the course of 1 year. The automated telephone technology was administered by means of an interactive response system, which evaluated whether or not patients were adherent to urate-lowering therapy with allopurinol. The primary end points were the proportion of patients who were adherent to therapy over 1 year, defined as having an adherence score of greater than or equal to 0.8, and having a serum urate of less than 6.0 mg/dL at 1 year.
After statistical analysis, the investigators found that patients in the intervention group showed a higher probability of medication adherence than those given standard care (50% vs 37%; odds ratio [OR], 1.68; 95% CI, 1.30-2.17; P <.001). In addition, a greater proportion of intervention patients achieved the target serum urate level (30% vs 15%; OR, 2.37; 95% CI, 1.83-3.05; P <.001).
Primary study limitations included the use passive follow-up techniques and administrative data sets to measure disease severity.
"A relatively simple intervention leveraging pharmacists and automated telephone technology led to significant improvements in adherence and achievement of urate goal in gout patients initiating allopurinol," the researchers wrote.
"While this light-touch, low-tech intervention was effective for some patients, additional efforts will be needed to ensure optimal management for an even greater proportion of gout patients," they concluded.
Mikuls TR, Cheetham TC, Levy GD, et al. A pharmacist-led intervention to improve gout medication adherence and outcomes with urate lowering therapy: a site randomized trial [published online November 29, 2018]. Am J Med. doi:10.1016/j.amjmed.2018.11.011