Oral and Poster Presentation 45th Annual ARA NSW-ACT Branch Meeting 2023

Implementing an Interprofessional Medication Adherence Program for People with Gout: A Pilot Feasibility Study (#19)

Brian Liang 1 , Helene Rickard 2 , Christabelle Elbitar 3 , David Martens 2 , Stephanie Frade 2 3 , Robyn Fairclough 4 , Vaireti Mafoe 4 , Sacha Bossina 2 , Lei Si 5 , Rashid Flewellen 6 , Stephen Carter 7 , Jian S Chan 1 , Kate Faasse 8 , Rebekah Moles 7 , Jonathan Penm 7 , Fatima Rezae 7 , Marie Schneider 9 , Sophie Stocker 1 7 , Ayano Kelly 1 2 3
  1. School of Health and Medicine, South Western Sydney Campus, University of New South Wales, Sydney, NSW, Australia
  2. Department of Rheumatology, Liverpool Hospital, Sydney, NSW, Australia
  3. Ingham Institute of Applied Medical Research, Sydney, NSW, Australia
  4. Consumer Research Partner, Sydney, NSW, Australia
  5. School of Health Sciences, Western Sydney University, Sydney, NSW, Australia
  6. School of Medicine, Western Sydney University, Sydney, NSW, Australia
  7. School of Pharmacy, University of Sydney, Sydney, NSW, Australia
  8. School of Psychology, Universtiy of New South Wales, Sydney, NSW, Australia
  9. Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland

Aim: Despite the availability of effective long-term therapies for gout, poor adherence to medication poses a significant barrier to effective treatment. This pilot study assesses the feasibility and acceptability of a nurse-led interprofessional medication adherence program for people with gout at Liverpool Hospital (Australia).

Method: Patients who meet the inclusion criteria are invited to participate in the pilot study; ≥18 years with gout; English or Arabic speaking; serum urate >0.36 mmol/L; previous hospital presentation with gout within the last 12 months; prescribed allopurinol.

A nurse provides monthly medication support, education, motivational interviewing and electronic adherence monitoring and feedback for 3 months. At the conclusion of the study, semi-structured interviews with patients and health professionals are conducted and thematically analysed to describe their experiences and satisfaction with the program. Interviews with executive hospital decision-makers were also conducted to evaluate program acceptability. Study participation (recruitment/attendance/attrition), adverse events, and intervention costs will also be evaluated.

Results: The IIMAP-Gout feasibility study recruited 10 patients from April to July 2023. This included 9 males and 1 female, with a mean age of 50. Participants predominantly identified as Pacific Islander (5), followed by Asian (4) and Caucasian (1). In total 30 eligible participants were contacted face-to-face or over the phone (average recruitment rate of 33%). Semi-structured interviews have been conducted with 2 patients, a rheumatologist and a clinical nurse specialist. Difficulties encountered throughout recruitment included patients not attending scheduled appointments, patients declining participation due to excessive time commitment and poor resource availability.

Discussion and Conclusion: Initial poor rates of recruitment to the service require further investigation. The pilot study will inform the feasibility and acceptability of the nurse-led interdisciplinary medication adherence program, allowing for further adaptions for a model of care that addresses barriers to medication adherence and improves outcomes in people with gout.