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Drivers of Satisfaction With Care for Patients With Lupus

Authors :
Meenakshi Jolly
Bhavika Sethi
Courtney O'Brien
Winston Sequeira
Joel A. Block
Sergio Toloza
Ana Bertoli
Ivana Blazevic
Luis M. Vilá
Ioana Moldovan
Karina D. Torralba
Elvira Cicognani
Davide Mazzoni
Sarfaraz Hasni
Berna Goker
Seminur Haznedaroglu
Josiane Bourre‐Tessier
Sandra V. Navarra
Chi Chiu Mok
Ann Clarke
Michael Weisman
Daniel Wallace
Source :
ACR Open Rheumatology, Vol 1, Iss 10, Pp 649-656 (2019)
Publication Year :
2019
Publisher :
Wiley, 2019.

Abstract

Objective Quality of life (QOL) and quality of care (QOC) in systemic lupus erythematosus (SLE) remains poor. Satisfaction with care (SC), a QOC surrogate, correlates with health behaviors and outcomes. This study aimed to determine correlates of SC in SLE. Methods A total of 1262 patients with SLE were recruited from various countries. Demographics, disease activity (modified Systemic Lupus Erythematosus Disease Activity Index for the Safety of Estrogens in Lupus Erythematosus: National Assessment trial [SELENA‐SLEDAI]), and QOL (LupusPRO version 1.7) were collected. SC was collected using LupusPRO version 1.7. Regression analyses were conducted using demographic, disease (duration, disease activity, damage, and medications), geographic (eg, China vs United States), and QOL factors as independent predictors. Results The mean (SD) age was 41.7 (13.5) years; 93% of patients were women. On the univariate analysis, age, ethnicity, current steroid use, disease activity, and QOL (social support, coping) were associated with SC. On the multivariate analysis, Asian participants had worse SC, whereas African American and Hispanic patients had better SC. Greater disease activity, better coping, and social support remained independent correlates of better SC. Compared with US patients, patients from China and Canada had worse SC on the univariate analysis. In the multivariate models, Asian ethnicity remained independently associated with worse SC, even after we adjusted for geographic background (China). No associations between African American or Hispanic ethnicity and SC were retained when geographic location (Canada) was added to the multivariate model. Canadian patients had worse SC when compared with US patients. Higher disease activity, better social support, and coping remained associated with better SC. Conclusion Greater social support, coping, and, paradoxically, SLE disease activity are associated with better SC. Social support and coping are modifiable factors that should be addressed by the provider, especially in the Asian population. Therefore, evaluation of a patient's external and internal resources using a biopsychosocial model is recommended. Higher disease activity correlated with better SC, suggesting that the latter may not be a good surrogate for QOC or health outcomes.

Details

Language :
English
ISSN :
25785745
Volume :
1
Issue :
10
Database :
Directory of Open Access Journals
Journal :
ACR Open Rheumatology
Publication Type :
Academic Journal
Accession number :
edsdoj.31c0257e19704594b25f6c6517621ff8
Document Type :
article
Full Text :
https://doi.org/10.1002/acr2.11085