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Table 1 Facilitators for medication adherence to allopurinol of febuxostat among African-Americans with gout

From: Facilitators and barriers to adherence to urate-lowering therapy in African-Americans with gout: a qualitative study



# Votes

Group 1 –African American men (four patients)

Adversity to pain

“If I don’t take it everyday, it (gout) would be back in my foot and anywhere.”


“It makes the pain stay away.”

“Gout is super painful- I’ll do whatever avoid that pain.”

“It hurts so bad, when I had gout.”

“I have been shot- I’d rather be shot again than have the pain due to gout.”

It is a habit

“It’s simple, once a day.”


“Once a week, I put all my medications in a compartment in the pill box.”

“It’s simple-take it once in the morning.”

“Put the pill in the napkin and take it to work.”

“It’s only 1 out of the 10 medications and it’s easy.”

It solved my problem

“When it first happened, I thought I hurt myself, then I was diagnosed with gout; allopurinol solved the problem.”


Avoid surgery/complications from other medications

“I had surgery from gout once and it is helping me avoid another- they drained gout from my foot.”


“Helps avoid prednisone- put on 60 pounds in 30 days.”

I do not recognize any bad side effects

“I don’t see any side effects.”


Can go places that I want to go

“Free to go anywhere”


“Can go to movie, park”

“Have my mobility”

“Makes me stay out of bed”

Allopurinol gives me a less restrictive diet

“Before allopurinol, certain foods triggered gout. Now I can eat anything I want in moderation.”


Group 2: African-American men (six patients)

I take allopurinol to stop the pain

“Prevent, minimize flare-up.”


“To be pain-free.”

“Help keep the pain under control.”

“I hurt so bad, I have to take it.”

“The pain is hell.”

“The pain was so bad, I couldn’t even walk.”

“That’s a given.”

It is a habit

“I have a habit.”


“(it’s a) routine”

“I take my meds in the morning- I wake up dry and take my meds with water in the morning.”

“I was taking my meds irregular, then over time it became regular.”

“Being consistent with my blood pressure med made me consistent with my allopurinol.”

Allopurinol is a good medicine that my family practice doctor can prescribe

“I don’t have to see a specialist.”


“It costs more and I have to drive longer to see a specialist, if I have to go to specialist; (I go) when a medication other than allopurinol is needed.”

When I am fine, my family is also

“Helps to keep the family to do things that they want to do.”


“If I am ok, my family is ok, everything “clicks”.”

To keep my mobility

“…To keep me walking.”


“Gout hit me so bad, both sides, I could do nothing; now I can do things.”

“Helps me walk inside and outside.”

“Activities I’d like to do.”

“I am very active, helps me stay active.”

“Let’s me do exercise, bicycling.”

“I can go on the treadmill.”

“Affects my quality of life positively.”

I purchase my meds (including allopurinol) every 90-days, it helps me not run out

“If I get 30-day prescription, I keep running out.”


“I do mail order for 90-days.”

“I get it at Costco.”

“90-day is cheaper than 30-day.”

I use a pill organizer, and organize my pills every two weeks

“ I have been using it (pill organizer) for years, that’s the one thing that helped, “that nailed it.”


“Just do it.”

“Keep it on the track.”

“Very effective.”

“You go back and see if you took it- sometimes I find out I didn’t take it.”

“It becomes more or less a protocol.”

Allopurinol is an everyday medication

“This is a medication, we have to take every day to keep it in our system.”


“If you get off for 2–3 days, it (gout) is coming back.”

Allopurinol gave them a less restrictive diet

“I can eat most things I want.”


Group 3: African-American men (five patients)*

I was requested by my doctor

“I have faith in my doctor.”


“Think doctors are here for a purpose.”

“My doctor knows the best.”


Take allopurinol to stop the gout from hurting

“The thought of flare-up (is scary).”


“The thought of the condition getting worsening, the pain becoming more severe…”

“Keeps me from having to rush to doctor’s office.”

“You have to take it.”

“Since being on allopurinol, I haven’t had a flare for 2 years.”

“Take allopurinol to prevent the handicap.”

“The thought of condition spreading to other foot.”

Because it helps to keep my uric acid in check

“The reason gout come is that uric acid builds up in the bone; Now uric acid is where it is supposed to be, that’s why my gout is away.”


I do not want to report to my doctor that I was not taking my allopurinol

“.. expectations from my doctor (My doc has set expectations).”


  1. *4 patients voted, one had to leave prior to voting.