Urate-lowering therapy adherence among gout patients in Southwest China: A cross-sectional study of determinants and regional disparities.

OBJECTIVE

Gout is directly associated with hyperuricemia. This study aims to investigate the adherence rate to urate-lowering therapy (ULT) and its influencing factors among patients with gout in Southwest China.

METHODS

A cross-sectional study was conducted involving 1023 gout patients treated at the Affiliated Hospital of Southwest Medical University between January 2022 and June 2025. Data were collected through telephone follow-ups and electronic medical record reviews. The Adherence to Refills and Medications Scale (ARMS) was used to assess ULT adherence among gout patients. A multivariate binary logistic regression model was used to analyze the correlation between independent variables.

RESULTS

The ULT adherence rate among gout patients was 31.6%. Multivariate binary logistic regression analysis revealed that smoking and alcohol consumption were independently associated with poor ULT adherence. Concurrent hypertension, concurrent diabetes, frequency of follow-up visits (> 3 times/year), confidence in maintaining serum uric acid within the normal range, awareness that the target serum uric acid level for ULT is 360 μmol/L, awareness that urate-lowering drugs should be taken long-term, and awareness that increased low-fat dairy intake benefits gout treatment were independently associated with good ULT adherence.

CONCLUSION

Adherence to ULT in Southwest China remains suboptimal but is higher than previously reported rates in other Chinese regions. We identified several modifiable factors-particularly disease knowledge, follow-up frequency, and lifestyle habits-that represent actionable targets for interventions to improve gout management in this underserved population. Key Points • The current status of ULT adherence among gout patients is suboptimal, and no existing surveys have examined ULT adherence rates among gout patients in Southwest China. • Our research findings indicated that the ULT adherence rate among gout patients was 31.6%. • Smoking and alcohol consumption were negatively associated with ULT adherence, whereas comorbid hypertension, diabetes, follow-up frequency exceeding three times per year, confidence, and gout-related knowledge were positively associated with improved ULT adherence.