SAT0420 IS THERE LIFE TO GOUT TREATMENT AFTER RHEUMATOLOGY IS OUT OF THE EQUATION?
Authors: Paula García, Boris Anthony Blanco Cáceres, Fernando Perez-Ruiz
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Previous studies show a low persistence rate to urate-lowering therapy (ULT), in patients diagnosed with gout, after being discharged back to primary care from Rheumatology consultations. <h3>Objectives:</h3> To assess persistence and adherence to ULT in patients with gout, previously evaluated in specialized care, who have been discharged from Rheumatology consultations to their primary care physician. <h3>Methods:</h3> A transverse study of patients with gout included in an inception cohort and followed in a tertiary care centre. Patients were selected according to their status of "discharge", in case they had been referred back to their primary care centre from specialized care, or "loss", in case they had stopped coming to Rheumatology consultations. Data, including active prescription of ULT, time since suspension of ULT (if applicable), last serum uric acid (sUA) levels and time for that determination, were procured by electronic history. General data of patients and follow-up were obtained from the database of such cohort. Patients lacking data or deceased were dismissed from the study. <h3>Results:</h3> A total of 518 patients, classified either as "discharge" or "loss", with available data accessed by electronic history, followed in specialized consultations during an average time of 52 months (36, 18-72) were studied. Average time since their last visit to Rheumatology services was 90 months (76, 36-132). 88% of them had, at least, one determination of sUA; 80% within the last 12 months, with no differences between the patients with or without active treatment. 376 patients (72.6%) out of 518 had an active prescription of ULT, 338 of them ordered by primary care and 38 by specialized care. Patients lost during follow-up showed a lower rate of ULT prescription and a higher requirement of specialized attention after than those who were discharged from Rheumatology. <h3>Conclusion:</h3> Patients discharged from Rheumatology consultations maintain good persistence to long-term treatment with ULT, higher than those who were lost during consultation follow-up. Nevertheless, persistence and adherence in the latter group show a higher rate than the ones obtained in patients being followed by primary care, which does not exclude a beneficial influence of the previous assistance provided by Rheumatology services. <h3>References</h3> [1] Aung T, Myung G, FitzGerald JD. Treatment approaches and adherence to urate-lowering therapy for patients with gout. Patient Prefer Adherence. 2017;11:795-800. Published 2017 Apr 19. doi:10.2147/PPA.S97927 [2] Perez-Ruiz F, Desideri G. Improving adherence to gout therapy: an expert review. Ther Clin Risk Manag. 2018;14:793-802. Published 2018 May 3. doi:10.2147/TCRM.S162956 [3] Scheepers L, van Onna M, Stehouwer C, et al. Medication adherence among patients with gout: A systematic review and meta-analysis. Semin Arthritis Rheum. 2018 Apr;47(5):689-702. doi: 10.1016/j.semarthrit.2017.09.007. Epub 2017 Oct 7. [4] Yin R, Li L, Zhang G, et al. Rate of adherence to urate-lowering therapy among patients with gout: a systematic review and meta-analysis. BMJ Open. 2018;8(4):e017542. Published 2018 Apr 10. doi:10.1136/bmjopen-2017-017542 <h3>Disclosure of Interests:</h3> Paula García: None declared, Boris Anthony Blanco Cáceres: None declared, Fernando Perez-Ruiz Grant/research support from: Asociación reumatólogos de Cruces, Consultant for: Grünenthal Horizon Menarini, Speakers bureau: Grünenthal, Menarini, Fundación Española Reumatologiá