Physician-patient interactions and outcomes in systemic lupus erythematosus (SLE): a conceptual model

Beusterien, K.; Bell, JA; Grinspan, Jessica; Utset, TO; Kan, Hong; Narayanan, S.

doi:10.1177/0961203313499958

Cited by 23 publications

(30 citation statements)

References 21 publications

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“…It is very important that a patient understands the substance of their disease, potential therapies, and factors that may affect the disease course. Cooperation with a doctor and patient awareness are of the key importance in such situations [20]. The awareness among our patients was good.…”

Section: Discussionmentioning

confidence: 55%

“…As much as 65.7% of patients stated that they possessed sufficient information on the disease, and 64% of patients stated that they were also aware of the therapy options. Sufficient patient awareness is one of the prerequisites for a successful therapy of SLE [20]. The most frequent sources of information for our patients were their attending doctor and the Internet.…”

Section: Discussionmentioning

confidence: 99%

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Living with Systemic Lupus Erythematosus: A Profile of Young Female Patients

Macejová

Gecková

Husárová

et al. 2020

IJERPH

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The aim is to describe a profile of systemic lupus erythematosus (SLE) patient (socio-demographic data, course of disease, health status, and health care utilization, SLE impact on their life, SLE awareness) and to explore the association of patient’s perspective with clinical indicators. Adult patients diagnosed by SLE were recruited in outpatient clinics (n = 76, 88% female, data collected in 2012–2016, Slovakia). The association of patients’ perspective (SLE status, health complaints during remission, SLE impact, hospitalizations) with clinical activity (European Consensus Lupus Activity Measurement Index—ECLAM) and inflammatory marker (erythrocyte sedimentation rate—ESR) was assessed by t-test for independent variables and one-way ANOVA. Almost 17.9% of patients reported relapse. During remission, they mostly suffered fatigue and pain. Nearly all patients were on chronic pharmacological treatment. Most of the patients assessed SLE impact on their life as restrictive (56.9%) or very restrictive (23.1%). The most frequent source of information was their physician, and 67.2% reported that they have sufficient information about the disease and its treatment. Only the association of SLE status and hospitalization with clinical activity (ECLAM) and inflammatory marker (ESR) were confirmed. With recent improvements in diagnostics and therapy options, the prognosis for patients with SLE has improved. Nevertheless, the impact of this disease on all areas of a patient’s life is extensive.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Living with Systemic Lupus Erythematosus: A Profile of Young Female Patients

Macejová

Gecková

Husárová

et al. 2020

IJERPH

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“…While we noted correspondences between various disease parameters and treatment satisfaction, cause and effect could not be established, although a cross-sectional survey of adults with SLE in the US has shown that steroid use was significantly associated with reduced patient satisfaction. 22 Despite its limitations, the current study is more likely to represent “real-world” findings than a controlled clinical trial. Additionally, this study provides the patient’s perspective, which is usually missing in clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction with control of systemic lupus erythematosus and lupus nephritis: physician and patient perspectives

Mozaffarian¹,

Lobosco²,

Lü³

et al. 2016

PPA

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PurposePatient satisfaction with disease control of systemic lupus erythematosus (SLE) is an important component of medical management. This analysis evaluated patient and physician satisfaction with disease control of SLE, factors associated with satisfaction/dissatisfaction, and the degree of physician–patient concordance of these parameters.Patients and methodsData were extracted from the US Adelphi Real World Lupus Disease Specific Programme®, a cross-sectional survey of 50 rheumatologists, 25 nephrologists, and their patients with non-nephritis SLE (NNSLE) or lupus nephritis (LN).ResultsPhysicians reported moderate or severe disease activity in 25.0% of patients with NNSLE and in 50.5% of patients with LN, and were satisfied with disease control in 78.6% (132/168) and 73.8% (152/206) of patients, respectively. For patients, 75.8% (75/99) with NNSLE were satisfied with their current treatment, compared with 65.5% (74/113) with LN. Physician–patient agreement (70.7%) on the level of satisfaction was “slight” (kappa =0.1445) for NNSLE; patients were more frequently dissatisfied than physicians with regard to joint tenderness, fatigue, anxiety, pain on movement, malar rash, and photosensitivity. Physician–patient agreement (71.4%) on the level of satisfaction was “fair” (kappa =0.3695) for LN; patients expressed greater dissatisfaction than physicians for headache, photosensitivity, and anxiety, whereas physicians were more dissatisfied with regard to joint swelling, kidney function, and blood pressure control. In general, patients with NNSLE or LN who were dissatisfied (or whose physicians were dissatisfied) were more likely to have joint swelling, joint stiffness, malar rash, hair loss, depression, and fatigue, have moderate or severe disease, or to be currently experiencing disease flare.ConclusionThese data highlight the patient and physician dissatisfaction with real-world disease control of SLE.

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“…m = 11.21; 95% CI 5.73–16.69; p < 0.001). Higher education level predicted and being white predicted more active participation Beusterien et al [ 24 ] To assess relationships between physician–patient relationship and patient outcomes including health status and regimen satisfaction in SLE USA Cross-sectional survey 302 SLE Patients’ perceptions of treatment regimen and satisfaction, physician–patient interactions including involvement in treatment decisions, physician bedside manner, satisfaction with physician, SLE control and severity, current health and hope about future health Positive physician–patient interactions led to higher satisfaction with treatment regimen and feeling well-controlled and more favourable perceptions of current health and being more hopeful about future health ( t = 6.10; t = 4.07) Ward et al [ 25 ] To examine associations between active patient–physician communication and measures of morbidity in patients with SLE USA Cross-sectional questionnaire study 79 SLE Patient communication behaviours coded as question asking, assertive responses, expressions of concern. Outcome measures assessed: depression (CES-D), SLE activity and morbidity SLAM, SLEDAI, SLICC/ACR Damage Index, Health Assessment Questionnaire (HAQ) Patients who participated more actively in their visits with physicians had less cumulative organ damage due to SLE.…”

Section: Methodsmentioning

confidence: 99%

Physician–patient communication in rheumatology: a systematic review

2018

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The nature of physician–patient interaction can have a significant impact on patient outcomes through information-sharing and disease-specific education that can enhance patients’ active involvement in their care. The aim of this systematic review was to examine all the empirical evidence pertaining to aspects of physician–patient communication and its impact on patient outcomes. A systematic search of five electronic databases (MEDLINE, PsycINFO, EMBASE, CINAHL, and Web of Science) was undertaken from earliest record to December 2016. Studies were eligible if they: (1) included adult participants (18 years or over) with a diagnosis of a rheumatic condition; (2) were of quantitative, qualitative or mixed methods design; (4) were surveys, observational and interventional studies; (5) were published in the English language; and (6) reported findings on either various physician–patient communication aspects alone or in combination with physical and psychological outcomes. Searches identified 455 papers. Following full-text retrieval and assessment for eligibility and quality, ten studies were included in the review; six quantitative, one mixed methods, and three qualitative papers. Higher levels of trust in the physician and active patient participation in the medical consultation were linked to lower disease activity, better global health, less organ damage accrual, greater treatment satisfaction with fewer side effects from the medication, more positive beliefs about control over the disease, and about current and future health. Future research could focus on the design and implementation of interventions incorporating communications skills and patient-education training.

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Physician-patient interactions and outcomes in systemic lupus erythematosus (SLE): a conceptual model

Abstract: The study findings informed a conceptual model of SLE patient-centered care that may be used to create more targeted education programs in the management of SLE, with the goal to improve patient outcomes.

Cited by 23 publications

References 21 publications

Living with Systemic Lupus Erythematosus: A Profile of Young Female Patients

Living with Systemic Lupus Erythematosus: A Profile of Young Female Patients

Satisfaction with control of systemic lupus erythematosus and lupus nephritis: physician and patient perspectives

Physician–patient communication in rheumatology: a systematic review

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