Guía de práctica clínica para el lupus eritematoso sistémico: recomendaciones para el abordaje clínico general

Effectiveness and cost-effectiveness of a multicomponent intervention to implement a clinical practice guideline for systemic lupus erythematosus: protocol for a cluster-randomized controlled trial

“…This consists of 6 h face-to-face group training divided into two sessions, 3 months apart. Contents of the first session are designed to attain the following objectives: 1) update evidence-based clinical knowledge on SLE management according to the contents of the SLE-CPG [10] and 2) develop skills to improve communication and negotiation abilities in the context of the person-centred care model [26] and shared decision making [25]. A set of short video-films and role-playing exercises representing different types of complex sham patients are used to deliver this intervention.…”

“…The aim is to train professionals to: 1) foster a climate of participation and establish clear and efficient communication; 2) elicit the patient’s concerns and preferences about possible decisions; and 3) promote shared decision making based on the best evidence, professional experience and the patient’s values and preferences in those decisions where either considerable uncertainty or several proven alternatives exists. The first part of the session is led by the clinical leader of the development of the SLE-CPG [10], a recognized rheumatologist expert in SLE, while the second part is led by two psychologists with proven expertise in patient-centred care methods and communication skills. The session also includes an explanation and training on use of the electronic decision aid tool (see below) led by the study’s principal researcher.…”

“…Rheumatologists included in the intervention group have access to an EDS system built by means of a computational algorithm from the CPG-SLE [10] and integrated into the electronic clinical record to provide evidence based recommendations personalized to the specific situation and needs of every patient. The tool is made available for patients included in the study [28].…”

“…For this purpose, the Spanish Ministry of Health funded development of the first complete and multidisciplinary clinical practice guideline (CPG) for the management of SLE (CPG-SLE) [10], including patients’ perspective [11]. This evidence-based CPG-SLE is intended to assist practitioner and patient decisions about the most appropriate healthcare for specific clinical circumstances.…”

Multiple/Overlap Autoimmune Syndrome: An Overlap of Systemic Lupus Erythematosus, Dermato-polymyositis and Non-insulin Dependent/Adult Onset Diabetes Mellitus Concomitant Herpes (Varicella) Zoster/Shingles, an Innovation

“…A 53-year-old woman, weighing 54 kg, a well-established case of systemic lupus erythemetosus (SLE), based on the criteria for its classification [6] as well as clinical practice guidelines [7] that included fever, feeling tired, red rash, painful and swollen joints, occasional chest pain, hair loss, in particular, alopecia totalis, recurrent mouth ulcers and swollen lymph nodes were the features of systemic LE whereas, the diagnosis of polymyositis was made on the basis of dysphagia, rapid onset (<4 weeks) of myositis, cutaneous necrosis and vasculitis, conforming to the criteria laid down for dermatomyositis and polymyositis. The concomitance of systemic lupus erythematosus and dermatomyositis/polymyositis has been a fascinating overture, and now stands well-recognized as an overlap syndrome [5,8] therefore, warranted elaborate laboratory background comprising several interrelated parameters, the salient details of which are being portrayed in the following (Table 1) for ready reference.…”