Many Gout Patients Not Receiving Recommended Urate-Lowering Rx
Patient- and practice-level factors account for 7.82 and 13.49 percent of prescribing variance in U.K.
TUESDAY, Dec. 23, 2014 (HealthDay News) -- For patients with incident gout, 44 percent fulfill indications for urate-lowering treatment at initial diagnosis, but many do not receive recommended treatment even years later, according to a research letter published in the Dec. 24/31 issue of the Journal of the American Medical Association.
Chang-Fu Kuo, M.D., from the Chang Gung Memorial Hospital in Taoyuan, Taiwan, and colleagues examined the timing of eligibility for and prescription of urate-lowering treatment following first gout diagnosis. Data were included for 52,164 patients in England, with incident gout in 1997 to 2010, identified using the Clinical Practice Research Datalink.
The researchers found that the median time to first treatment indication was five months. The cumulative probability of fulfilling any indication at time from diagnosis was 44.26 percent at 0 years, 61.02 percent at one year, 86.81 percent at five years, and 94.27 percent at 10 years. At the same time points, the cumulative probabilities for prescription were 0, 16.90, 30.39, and 40.52 percent, respectively. Among practices, the median prescription rate for urate-lowering treatment was 32.5 percent. Patient-level factors accounted for 7.82 percent of total prescription variance, while practice-level factors accounted for 13.49 percent. Most indications for treatment correlated with increased prescribing.
"Our study supports including urate-lowering treatment in the information about gout provided to patients around the time of first diagnosis," the authors write.
Two authors disclosed financial ties to pharmaceutical companies.