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Impact of adherence to EULAR quality indicators on the quality of life of patients with systemic lupus erythematosus

Published:December 28, 2022DOI:https://doi.org/10.1016/j.ejim.2022.12.019

      Highlights

      • Impaired quality of life in SLE can be of greater concern from the patient's perspective than disease activity assessed by the physician.
      • Adherence to EULAR-based QIs by physicians does not suffice to provide a favorable impact on the quality of life of SLE patients.
      • An integrated disease modification approach, based on disease activity indices and subjective patients’ wellness, should be considered as primary end point in clinical trials.

      Abstract

      Objective

      Quality indicators (QIs) for systemic lupus erythematosus (SLE) management based on the 2019 update of European League Against Rheumatism (EULAR) recommendations have been recently proposed. We aimed to determine whether adherence to QIs was associated with patient reported outcome (PRO).

      Methods

      Adherence to a set of 18 EULAR-based QIs and correlation with PRO assessed by Lupus Impact Tracker (LIT) was tested in a cohort of 162 SLE patients.

      Results

      On average, SLE patients received 41% (33; 52.5) of recommended care. Higher adherence to monitoring-related QIs was associated with an older age, a shorter SLE disease duration and a more severe disease (i.e. Class III/IV/V nephritis). LIT demonstrated that the average impact of lupus on patients’ life was of 30% (12.5;47.5). In multivariable analysis, patients of female gender (OR 0.25, 95% 0.05–0.94; p = 0.05), with lupus CNS (OR 0.33, 95%CI 0.08–1.05; p = 0.08) and skin involvements (OR 0.49, 95%CI 0.23–1.04; p = 0.07) had higher odds of experiencing a negative impact of the lupus on their life. No association were found between adherences to QIs by physicians and reported quality of life in lupus patients.

      Conclusion

      Our study confirms a variable degree of clinicians’ adherence to QIs for SLE and shows no clear association between QIs adherence and patient reported outcome. Adherence to QIs by physicians are not enough to impact the quality of life of patients.

      Keywords

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