Adherence to urate-lowering therapy among people with gout is poor and understanding which day-to-day medication-taking (‘implementation’) patterns are most likely to lead to suboptimal serum urate concentrations can help improve clinical outcomes.

Missing one or two doses of allopurinol, even repeatedly over a year, does not significantly impact serum urate target achievement or clinical outcomes.

People who take repeated drug holidays of more than 3 days in a row (followed by less than 15 consecutive days of dosing) are at least 70% less likely to achieve adequate urate control than those with perfect implementation.