The association of socio-economic status, race, psychosocial factors and outcome in patients with systemic lupus erythematosus

Sutcliffe, Nurhan; Clarke, Ann E.; Gordon, Caroline; Farewell, Vernon T.; Isenberg, DA

doi:10.1093/rheumatology/38.11.1130

Cited by 123 publications

(113 citation statements)

References 21 publications

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“…Global physical function was improved by 7 points on the SF-36; although this change was not statistically significant, it is greater than the minimum clinically significant change suggested for interpreting change scores in rheumatoid arthritis trials (59). The clinical trial results confirm cross-sectional findings from research done by our group and other investigators, and support the importance of psychosocial factors in outcome in SLE (8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionsupporting

confidence: 69%

“…Self-efficacy has been correlated with SLE outcome in several studies (8)(9)(10)(11)(12)(13)(14)(15) and has been found to consistently predict health-related outcomes in prospective studies (60). In this trial, we demonstrated that self-efficacy could be enhanced by our intervention and that it was a key predictor of mental health status and fatigue outcomes.…”

Section: Discussionmentioning

confidence: 53%

“…What was more significant, perhaps, was that both self-efficacy and social support could likely be improved with targeted interventions, thus making these factors the first examples of modifiable, nonmedical risk factors associated with SLE outcomes. Since that time, other studies have confirmed the importance of psychosocial factors and outcome in SLE (9)(10)(11)(12)(13)(14)(15).…”

mentioning

confidence: 83%

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A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

Karlson¹,

Liang²,

Eaton³

et al. 2004

Arthritis & Rheumatism

159

157

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Objective. In a cross-sectional study, we previously identified 2 potentially modifiable risk factors for adverse outcomes in systemic lupus erythematosus (SLE): self-efficacy and social support. The goal of this study was to evaluate in a randomized controlled trial a theory-based intervention to improve patient selfefficacy and partner support to manage SLE.Methods. Patients with SLE ages 18 years and older who met the American College of Rheumatology criteria and were able to identify a partner (spouse or family member) were recruited from 2 academic medical centers and randomized into an experimental group or a control group. Patients in the experimental group and their partners received an intervention designed to enhance self-efficacy, couples communication about lupus, social support, and problem solving, in the form of a 1-hour session with a nurse educator followed by monthly telephone counseling for 6 months. Patients in the control group and their partners received an attention placebo, including a 45-minute video presentation about lupus, and monthly telephone calls. Measures of physical and mental health status, disease activity, and psychosocial factors were collected at baseline, 6 months, and 12 months. The effect of the intervention on physical and mental health and disease activity at 6 and at 12 months was modeled with linear regression and adjusted for baseline health status, disease activity, sociodemographic factors, treatment change, and psychosocial factors.Results. One hundred twenty-two patients (plus their partners) were enrolled and randomized as follows: 64 to the experimental intervention and 58 to the attention control group. The participants were predominantly white, approximately half were college educated, and the groups were balanced for sociodemographic factors. At 6 months, significantly higher scores for couples communication (P ‫؍‬ 0.01) and problem-focused coping (P ‫؍‬ 0.03) were seen in the experimental group compared with the control group. At 12 months (6 months after the intervention ended), social support was higher (4.4 versus 4.1; P ‫؍‬ 0.03), self-efficacy was higher (7.2 versus 6.2; P ‫؍‬ 0.02), couples communication was higher (3.5 versus 3.1; P ‫؍‬ 0.03), and fatigue was lower (5.1 versus 6.3; P ‫؍‬ 0.02) in the experimental group compared with the control group. Global mental health status at 12 months, as measured by the Short Form 36 survey, was 69 points in the experimental group compared with 58 points in the control group (P ‫؍‬ 0.04). In multivariate models, adjusting for baseline covariates, scores for couple communication (P ‫؍‬ 0.01) were significantly higher at 6 months, and scores for self-efficacy (P ‫؍‬ 0.004) and global mental health status (P ‫؍‬ 0.03) were significantly higher at 12 months in the experimental group compared with the control group, and the mean score for global physical function was higher by 7 points, which was a clinically meaningful

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 53%

mentioning

confidence: 83%

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A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

Karlson¹,

Liang²,

Eaton³

et al. 2004

Arthritis & Rheumatism

159

157

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“…Risk factors for damage identified in adult patients with SLE include older age at diagnosis (30,32,33,36), longer duration of SLE (32,35,36), African Caribbean or Asian ethnicity (30,35), lower level of education (35), higher disease activity at diagnosis (32,33,36), greater overall activity during disease course (31,34), and cumulative and high-dose prednisone (37). By means of multivariate logistic regression analyses, we found that the presence of NPS involvement at diagnosis, a longer duration of SLE, and a greater number of intravenous cyclophosphamide pulses were the strongest determinants of cumulative organ damage in our cohort of juvenile-onset SLE patients.…”

Section: Discussionmentioning

confidence: 99%

Assessment of damage in juvenile‐onset systemic lupus erythematosus: A multicenter cohort study

Ravelli¹,

Duarte-Salazár²,

Buratti³

et al. 2003

Arthritis & Rheumatism

151

131

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Objective. To investigate the prevalence of cumulative organ damage in patients with juvenile-onset systemic lupus erythematosus (SLE) and its association with demographic and clinical variables, medication use, and quality of life. Methods. The occurrence of organ system damage, as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), was determined for 387 patients consecutively enrolled in pediatric rheumatology centers from Europe, the US, Mexico, and Japan. Risk factors for damage included demographic variables; clinical manifestations at diagnosis; previous corticosteroid, immunosuppressive, and antimalarial therapies; disease activity; and quality of life. Results. Overall, 195 (50.5%) patients had damage within a mean of 5.7 years after disease onset. Renal (21.8%) and neuropsychiatric (15.8%) system involvement were observed most frequently, followed by musculoskeletal (11.7%), ocular (10.9%) and skin (9.6%) system involvement, with a mean SDI score of 1.1. In multivariate models, the occurrence of neuropsychiatric manifestations at diagnosis, a longer disease duration, and a greater number of intravenous cyclophosphamide pulses showed the strongest association with the presence of damage. Conclusion. We found evidence of cumulative organ damage, as measured by the SDI, in half of the patients with juvenile-onset SLE. Damage was significantly more likely in patients who had experienced neuropsychiatric manifestations at diagnosis, had a longer disease duration, and had received more intravenous pulses of cyclophosphamide.

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“…Newer biologics and antiviral agents have been reported to cause drug-induced lupus (DIL) [23]. Socioeconomic factors have been associated with poorer outcomes and higher disease activity, [24] although it remains unclear whether they play a role in disease susceptibility or subsequent progression.…”

Section: Environmental Factorsmentioning

confidence: 99%

Proteomic analysis of human plasma and peripheral blood mononuclear cells in Systemic Lupus Erythematosus patients

Pinna

Pasella

Deiana³

et al. 2017

Journal of Immunological Methods

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The association of socio-economic status, race, psychosocial factors and outcome in patients with systemic lupus erythematosus

Abstract: Race and socio-economic status, as well as clinical and psychosocial factors, determine outcome in SLE.

Cited by 123 publications

References 21 publications

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus

Assessment of damage in juvenile‐onset systemic lupus erythematosus: A multicenter cohort study

Proteomic analysis of human plasma and peripheral blood mononuclear cells in Systemic Lupus Erythematosus patients

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