{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T22:43:36Z","timestamp":1790981016820,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,23]],"date-time":"2024-06-23T00:00:00Z","timestamp":1719100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000241","name":"PSI Foundation","doi-asserted-by":"publisher","award":["R23\u201022"],"award-info":[{"award-number":["R23\u201022"]}],"id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to evaluate urate\u2010lowering therapy (ULT) adherence and treatment\u2010to\u2010target (T2T) serum uric acid (SUA) levels among older adults with gout starting ULT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a population\u2010based retrospective cohort study in Ontario, Canada in patients with gout aged \u226566 years newly dispensed ULT between 2010 and 2019. We defined successful T2T as patients having SUA levels &lt;360 \u03bcmol\/L (6 mg\/dL) within 12 months after ULT dispensation. We also assessed adherence to ULT. Multilevel logistic regression clustered by ULT prescriber evaluated patient, physician, and prescription factors associated with reaching target SUA levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 44,438 patients (mean \u00b1 SD age 76.0 \u00b1 7.3 years; 64.4% male), 30,057 (67.6%) patients had \u22651 SUA test completed. Overall, 52.3% patients reached SUA target within 12 months, improving from 45.2% in 2010 to 61.2% in 2019 (<jats:italic>P<\/jats:italic> &lt; 0.0001). ULT adherence was 55.3% overall and improved annually. Key factors associated with achieving T2T included febuxostat treatment (odds ratio [OR] 11.40, 95% confidence interval [95% CI] 5.10\u201325.43) (was only dispensed in 88 patients), ULT adherence (OR 5.17, 95% CI 4.89\u20135.47), allopurinol starting doses &gt;50 mg (OR 2.53, 95% CI 2.14\u20132.99), colchicine\/oral glucocorticoids co\u2010prescription (OR 1.24, 95% CI 1.14\u20131.34), and ULT prescription from a rheumatologist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Only 52.3% of patients achieved an optimal SUA level within 1 year of ULT initiation. ULT adherence was suboptimal, although improving over time. ULT adherence and higher allopurinol starting doses had the strongest associations of achieving a target SUA level. This study highlights room for improvement in gout management and potential strategies to address care gaps.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25380","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T02:14:20Z","timestamp":1717467260000},"page":"1379-1389","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Adherence and Treat\u2010to\u2010Target Benchmarks in Older Adults With Gout Initiating Urate\u2010Lowering Therapy in Ontario, Canada: A Population\u2010Based Study"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0354-4794","authenticated-orcid":false,"given":"Timothy S. H.","family":"Kwok","sequence":"first","affiliation":[{"name":"University of Toronto and Sunnybrook Research Institute, Holland Bone &amp; Joint Program  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3370-0006","authenticated-orcid":false,"given":"Bindee","family":"Kuriya","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6358-1197","authenticated-orcid":false,"given":"Gillian","family":"Hawker","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-1715","authenticated-orcid":false,"given":"Lihi","family":"Eder","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Li","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Choy","sequence":"additional","affiliation":[{"name":"University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-0460","authenticated-orcid":false,"given":"Jessica","family":"Widdifield","sequence":"additional","affiliation":[{"name":"University of Toronto, Sunnybrook Research Institute, Holland Bone &amp; Joint Program, and ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20405"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.071229"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.10511"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(21)00319-2"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32158-5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24180"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209707"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23500"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2021.04.011"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140588"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22336"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017542"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25167"},{"key":"e_1_2_7_15_1","first-page":"679","article-title":"Drug\u2010induced hyperuricaemia and gout","volume":"56","author":"Ben Salem C","year":"2017","journal-title":"Rheumatology (Oxford)"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25009"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080768"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160300"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/03007995.2020.1793312"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2018.01290"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12350-019-01624-z"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2022-1109"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2017.03.013"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92244-N"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex156"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100416"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13032"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.190522"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42731"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar4524"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kex530"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9121639"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.071530"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket158"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-023-06532-9"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40256-020-00400-6"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.01.055"},{"key":"e_1_2_7_39_1","first-page":"evidoa2100028","article-title":"Comparative effectiveness of allopurinol and febuxostat in gout management","volume":"1","author":"O'Dell JR","year":"2022","journal-title":"NEJM Evid"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-210352"}],"container-title":["Arthritis Care &amp; 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