Abstract
Despite guidance on appropriate initiation, urate-lowering therapy is prescribed for only a minority of patients with gout. Electronic health records for 8,142 patients with gout were used to investigate the effect of age, sex, comorbidities, number of consultations, and meeting internationally agreed eligibility criteria on time to allopurinol initiation. Time to first prescription was modeled using multilevel Cox proportional hazards regression. Allopurinol initiation was positively associated with meeting eligibility criteria at diagnosis of gout, but negatively associated with becoming eligible after diagnosis. Managing gout as a chronic disease, with regular reviews to discuss allopurinol treatment, may reduce barriers to treatment.
Footnotes
Conflicts of interest: authors report none.
Funding support: Funding was from the National Institute of Health Research School for Primary Care Research (NIHR SPCR). LEC is supported by a National Institute for Health Research Academic Clinical Lectureship. CDM is funded by a UK National Institute for Health Research (NIHR) Research Professorship (NIHR-RP-2014-04-026), the NIHR Collaborations for Leadership in Applied Health Research and Care West Midlands, and the NIHR School for Primary Care Research.
- Received for publication July 27, 2016.
- Revision received February 23, 2017.
- Accepted for publication April 28, 2017.
- © 2017 Annals of Family Medicine, Inc.
