{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:56:14Z","timestamp":1788350174870,"version":"build-2803163510"},"reference-count":46,"publisher":"The Journal of Rheumatology","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To assess factors associated with the ability to achieve and maintain target serum urate (SU) with allopurinol in patients with gout.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We used US Veterans Affairs (VA) databases from 2002\u20132012. Eligible patients had \u2265 1 inpatient or \u2265 2 outpatient visits with a diagnostic code for gout, filled a new index allopurinol prescription, had at least 1 posttreatment SU level measured, and met the 12-month observability rule. Treatment successes were defined as the achievement of postindex SU &lt; 6 mg\/dl (success 1) and postindex SU &lt; 6 mg\/dl that was sustained (success 2).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Of the 198,839 unique patients with allopurinol use, 41,153 unique patients (with 47,072 episodes) and 17,402 unique patients (with 18,323 episodes) were eligible for analyses for success 1 and success 2; 42% each achieved (success 1) or achieved and maintained postindex SU &lt; 6 mg\/dl (success 2). In multivariable-adjusted models, factors associated with significantly higher odds of both outcomes were older age, normal body mass index, Deyo-Charlson index score of 0, rheumatologist as the main provider rather than non-rheumatologist, midwestern US location for the healthcare facility, a lower hospital bed size, military service connection for medical conditions of 50% or more (a measure of healthcare access priority), longer distance to the nearest VA facility, and lower preindex SU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>We identified novel factors associated with maintaining SU &lt; 6 mg\/dl based on a theoretical model. Several potentially modifiable factors can be targeted by individual\/provider\/systems interventions for improving successful achievement and maintenance of target SU in patients with gout.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.190522","type":"journal-article","created":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T16:28:32Z","timestamp":1565886512000},"page":"449-460","source":"Crossref","is-referenced-by-count":18,"title":["Factors Influencing the Effectiveness of Allopurinol in Achieving and Sustaining Target Serum Urate in a US Veterans Affairs Gout Cohort"],"prefix":"10.3899","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3485-0006","authenticated-orcid":false,"given":"Jasvinder A.","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth G.","family":"Saag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2019,8,15]]},"reference":[{"key":"2020030109251116000_47.3.449.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.092619"},{"key":"2020030109251116000_47.3.449.2","doi-asserted-by":"publisher","DOI":"10.4065\/81.7.925"},{"key":"2020030109251116000_47.3.449.3","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh679"},{"key":"2020030109251116000_47.3.449.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.rhu.0000209882.50228.9f"},{"key":"2020030109251116000_47.3.449.5","doi-asserted-by":"publisher","DOI":"10.1002\/art.20405"},{"key":"2020030109251116000_47.3.449.6","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken457"},{"key":"2020030109251116000_47.3.449.7","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080814"},{"key":"2020030109251116000_47.3.449.8","doi-asserted-by":"publisher","DOI":"10.1080\/15257770802136032"},{"key":"2020030109251116000_47.3.449.9","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3181945d2c"},{"key":"2020030109251116000_47.3.449.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1169"},{"key":"2020030109251116000_47.3.449.11","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"2020030109251116000_47.3.449.12","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21773"},{"key":"2020030109251116000_47.3.449.13","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.055269"},{"key":"2020030109251116000_47.3.449.14","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/rheumatology\/kex156","article-title":"The British Society for Rheumatology guideline for the management of gout","volume":"56","author":"Hui","year":"2017","journal-title":"Rheumatology"},{"key":"2020030109251116000_47.3.449.15","doi-asserted-by":"publisher","DOI":"10.1080\/15257770.2011.596496"},{"key":"2020030109251116000_47.3.449.16","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203325"},{"key":"2020030109251116000_47.3.449.17","doi-asserted-by":"publisher","DOI":"10.7326\/M16-0570"},{"key":"2020030109251116000_47.3.449.18","doi-asserted-by":"publisher","DOI":"10.1185\/03007995.2011.552570"},{"key":"2020030109251116000_47.3.449.19","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903017966"},{"key":"2020030109251116000_47.3.449.20","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140588"},{"key":"2020030109251116000_47.3.449.21","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209467"},{"key":"2020030109251116000_47.3.449.22","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209707"},{"key":"2020030109251116000_47.3.449.23","doi-asserted-by":"publisher","DOI":"10.2307\/3349613"},{"key":"2020030109251116000_47.3.449.24","doi-asserted-by":"publisher","DOI":"10.2307\/2137284"},{"key":"2020030109251116000_47.3.449.25","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/152.4.307"},{"key":"2020030109251116000_47.3.449.26","doi-asserted-by":"publisher","DOI":"10.12927\/hcpap.17381"},{"key":"2020030109251116000_47.3.449.27","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1728"},{"key":"2020030109251116000_47.3.449.28","doi-asserted-by":"publisher","DOI":"10.1023\/A:1020579806511"},{"key":"2020030109251116000_47.3.449.29","first-page":"424","article-title":"Evaluating and improving pressure ulcer care: The VA experience with administrative data","volume":"23","author":"Berlowitz","year":"1997","journal-title":"Jt Comm J Qual Improv"},{"key":"2020030109251116000_47.3.449.30","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199809000-00005"},{"key":"2020030109251116000_47.3.449.31","first-page":"37","article-title":"Accuracy of computerized outpatient diagnoses in a Veterans Affairs general medicine clinic","volume":"8","author":"Szeto","year":"2002","journal-title":"Am J Manag Care"},{"key":"2020030109251116000_47.3.449.32","unstructured":"STROBE statement . 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