For a study, researchers sought the reasons patients provide for not taking allopurinol and to see if there were any differences in intentional non-adherence between patients with and without serum urate at the treatment target. About 69 men completed the Intentional Non-Adherence Scale (INAS) with gout who visited rheumatology clinics and were all taken allopurinol for at least 6 months. In addition, the forms of intentional non-adherence were compared between individuals who had a serum urate (SU) at the treatment target (0.366mmol/L, 6mg/dL) and those who did not.

Patients desired to live a normal life (23%) or think of themselves as a healthy person again as one of the most often endorsed reasons for not taking their urate-lowering medication (20%). Patients also said they didn’t take allopurinol to see if they needed it (22%). Patients with an SU over goal endorsed significantly more INAS items as reasons for not taking their medicine, had higher medicine-related anxieties, and were more likely to blame non-adherence on testing treatment. Younger, single, and non-NZ European participants cited higher reasons for not taking their allopurinol.

The desire to live a normal life and the treatment method to determine if patients might reduce the dose without experiencing effects were two major factors in the decision not to take allopurinol. The findings present clinicians with some potentially adjustable objectives for adherence interventions and some clues about how urate-lowering treatment should be purposefully framed for patients to increase adherence.