Evere, the patients organizing their pills and their routine so that
Evere, the patients organizing their pills and their routine so that they would not forget to take their ULT, the patient’s ability to have fewer dietary restrictions and the ability to eat foods they liked in moderation once they were taking ULT regularly, lack of side effects, avoidance of side Quisinostat supplier effects from alternatives such as corticosteroids, trust in physicians, and avoiding the need to seek frequent emergent/urgent care or a subspecialist’s care. Several findings from PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/27872238 this study deserve further discussion. It is now well-known that compared to Caucasians, African-Americans not only have a higher prevalence of gout [1], but also have more severe gout with higher baseline sUA, worse ULT adherence and lower likelihood of ULT treatment and the achievement of target sUA <6 mg/dl [17-19]. This disproportionate burden of gout and the lack of any previously published studies on racial minorities were the key motivations for our study. Several findings in this study are novel. Both low and high adherers to ULT identified issues related to body medication, identity-relevant functions (interference or facilitation) and meaning imparted to the mediation as key facilitators and barriers to ULT adherence, that fit our theoretical model, that is, the trajectory model with the BBC chain [23,24]. The themes were opposite in several common domains. A key difference in low vs. high adherers was their understanding of what the medication could/would do for them. The low adherers were notconvinced that ULT was needed every day or was helping their gout vs. high adherers who had the very opposite experience and perception, that is, the ULT helped them avoid severe pain and suffering. Low adherers cited lack of knowledge and communication from physicians regarding the usefulness of ULT, an important observation from our study, complimenting a survey study finding that knowledge deficits were common in gout patients [14]. High adherers had greater trust in their physicians and saw the adherence to ULT as a way to avoid more doctor visits, keep their uric acid levels in check and prevent chronic joint damage that reflected more knowledge about gout and treatments. The current study also provides an in-depth examination of ULT adherence in African-Americans. Some quotes from patients were eye-openers; for example, one veteran who had served in the armed forces said, "I have been shot. I'd rather be shot than have my gout attack again", signifying the severe pain of gout and its impact on patients and why it is so important to adequately treat gout. This study adds knowledge to the area by identifying additional previously not-described barriers, such as the impact of concomitant medications and of taking too many pills, ULT pill size, swallowing difficulty, patient preference for alternative medicines, travel-related and refill issues, and competing priorities. These findings indicate that non-medication alternatives are considered true alternatives to pharmacotherapy by patients and should be discussed with patients with gout. Now that these barriers have been identified, a furtherSingh Arthritis Research Therapy 2014, 16:R82 http://arthritis-research.com/content/16/2/RPage 11 ofstudy into how to develop interventions targeting these barriers is needed. Patient education and patientphysician communication can target several barriers and has the potential to improve the outcomes in AfricanAmericans with gout. Gaps in patient and physician knowledge have.
