Effectiveness of a Drug Reminder Application on Adherence to Uric Acid-Lowering Therapy in Gout Patients: A Randomized Trial (Eng)
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Abstract
Introduction: Almost half of gout patients fail to achieve target serum uric acid (SUA) levels due to poor adherence to urate-lowering therapy (ULT), leading to adverse outcomes and increased healthcare costs. Mobile health applications (apps) have become effective tools for improving medication adherence in patients with chronic diseases.
Objectives: This study aimed to evaluate the effectiveness of a drug reminder mobile app in improving adherence to ULT in gout patients with poor adherence.
Methods: We conducted an open-label, randomized controlled trial involving 54 gout patients with SUA > 6 mg/dL and poor adherence to ULT. Patients were randomly assigned to either the "Drug Diary" reminder app group (N=25) or the "Roo-Rak-Koh" patient education app group (N=29). Co-primary outcomes included ULT adherence (measured by the MTB-T questionnaire), pill count adherence, and the proportion of patients achieving the SUA target (<6 mg/dL). A stable ULT dose was maintained throughout the study.
Results: At 12 weeks, the proportion of patients with high ULT adherence and pill count adherence were higher in the drug reminder app group (63% vs 37%, p=0.102 for MTB-T and 96% vs 93%, p=0.615 for pill count). SUA target achievement was similar in both groups (48% vs 47.8%, p=0.89). However, SUA reduction was significantly greater in the drug reminder app group (-1.63 ± 1.18 vs -0.76 ± 1.24, p=0.01).
Conclusions: Mobile health applications, including drug reminder and patient education apps, may improve medication adherence. The integration of both apps could offer complementary benefits in gout management
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