Systemic lupus erythematosus in three ethnic groups. XI. Sources of discrepancy in perception of disease activity: A comparison of physician and patient visual analog scale scores

Alarcón, Graciela S.; McGwin, Gerald; Brooks, Kemi; Roseman, Jeffrey M.; Fessler, Barri J.; Sanchez, Martha L.; Bastian, Holly M.; Friedman, Alan Warren; Baethge, Bruce A.; Reveille, John D.

doi:10.1002/art.10512

Cited by 90 publications

(84 citation statements)

References 15 publications

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“…One important confounding factor influencing noncompliance may be unawareness of specific clinical features indicative of disease activity; this is particularly the case for disease manifestations that are primarily expressed as laboratory abnormalities and that are frequent among nonCaucasian patients. Under such circumstances, patients may not perceive themselves as being sick and in need of medical care [41]; physicians need to spend additional time with these patients so that they take their laboratory abnormalities (eg, urinalysis) more seriously, particularly in terms of their possible impact on organ outcome and survival. …”

Section: Factors Explaining Ethnic Disparitiesmentioning

confidence: 98%

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Ethnic disparities in patients with systemic lupus erythematosus

Uribe¹,

Alarcón

2003

Curr Rheumatol Rep

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Ethnic disparities in health care have been historically well documented, but their causes still remain poorly explained. In the US, ethnic minorities have a higher incidence and prevalence of systemic lupus erythematosus and also experience less favorable outcomes when compared with the Caucasian majority. These discrepancies can be explained, at least in part, by genetic-related ethnic factors; however, nongenetic factors emerging from differences in socioeconomic status and related individual social (poverty, limited access to quality health care) and cultural characteristics (inadequate health belief patterns, distrust in medical institutions) are also likely to contribute to these discrepancies. A comprehensive recognition of current unfavorable, but modifiable, circumstances will provide the framework to develop strategic approaches toward eliminating existent disparities in health, including those occurring in patients with systemic lupus erythematosus.

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Section: Factors Explaining Ethnic Disparitiesmentioning

confidence: 98%

“…Alarcón et al [41] Patients may perceive themselves as having low disease activity if predominant manifestations are abnormal laboratory findings…”

Section: References and Recommended Readingmentioning

confidence: 99%

Ethnic disparities in patients with systemic lupus erythematosus

Uribe¹,

Alarcón

2003

Curr Rheumatol Rep

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“…In the current study, PGA, the subjective disease activity measure by patients' perspective was significantly associated with depression while SLEDAI, the objective disease activity measure was not associated with depression in accordance with previous researches. Additionally, PhyGA, the subjective disease activity measure by physician's perspective were not correlated with depression, which suggest the discrepancy in assessment of disease activity according to patient's or physician's perspective in line with preceding study [29]. Because of diverse clinical manifestations and no standardized blood test to assess disease status, improvement of HRQoL is one of important treatment target in patients with SLE [11].…”

Section: Discussionmentioning

confidence: 86%

Depression and Quality of Life in Patients with Systemic Lupus Erythematosus

et al. 2015

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Objective. The objective of this study is to examine the prevalence of depression and its related factors including quality of life, brain-derived neurotrophic factor (BDNF), and vitamin D in patients with systemic lupus erythematosus (SLE). Methods. Depression was assessed using the center for epidemiologic studies depression (CES-D) scale. Disease activity, disease-related organ damage, the EuroQol-5 dimensions (EQ-5D), sociodemographic features, and laboratory tests including serum vitamin D level were surveyed. Serum BDNF was measured using an enzyme-linked immunosorbent assay. Results. Depression was observed in 22.8% of 180 SLE patients (n=41). Patients with marital status of single/divorced/separated/widowed, a higher patient global assessment (PGA) score, and extreme pain/discomfort showed significant association with depression. The EQ-5D index showed negative correlation with CES-D score (r=−0.56, p＜0.05). In each EQ-5D dimension, depression showed significant association with moderate to severe problems in self-care and usual activities, and extreme pain/discomfort. Serum BDNF levels were not associated with depression (p=0.75) but associated with SLE disease activity index (SLEDAI; r=−0.21, p＜0.05). Serum vitamin D levels were not associated with depression (p=0.60) but showed negative correlation with SLEDAI (r=−0.23, p＜0.05) and mean glucocorticoid dose over the previous 3 months (r=−0.21, p＜0.05) after adjustment for use of vitamin D supplement. Conclusion. Depression was prevalent in patients with SLE and was associated with low quality of life, and a higher PGA but not with SLEDAI. Serum BDNF and vitamin D levels were not associated with depression but showed negative correlation with SLEDAI. (J Rheum Dis 2015;22:346-355)

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“…However, patients and physicians may rate ongoing disease activity differently, and two different physicians may even rate them differently. Patients are more likely to perceive effects of the disease on their daily function, whereas physicians rely on visible/discernible effects of the disease, placing a greater weight on the clinical history, physical examination, and laboratory assessments [9]. Patient quality-of-life evaluations and physician assessments may not follow the same algorithms in routine clinical care and RCTs.…”

Section: Domains Important To Patients In Routine Clinical Care and Imentioning

confidence: 96%

Treatment of Lupus: Impact on Quality of Life

Toloza¹,

Sequeira

Jolly

2011

Curr Rheumatol Rep

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Systemic lupus erythematosus (SLE) is an autoimmune disease that disproportionately affects women of childbearing age during their most productive years. Current therapeutic measures have improved patient survival; however, the impact of interventions on general and specific domains of health-related quality of life requires further study. Medical Outcomes Survey Short Form 36 (SF-36), the most commonly used measure, has been included in some SLE randomized controlled trials, but the observed effect sizes were generally small and in some cases negligible. An SLE patient's quality of life is known to be significantly worse than that of someone in the general population and perhaps worse than those with most other common chronic diseases. SF-36, although useful as a general measure, may not be the most sensitive way to gauge changes perceived by patients with SLE. Ongoing trials and observational longitudinal studies using lupus-specific health-related quality-of-life measures may help better determine health-related quality-of-life responses and determine the domains most amenable to interventions.

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Systemic lupus erythematosus in three ethnic groups. XI. Sources of discrepancy in perception of disease activity: A comparison of physician and patient visual analog scale scores

Abstract: Patients and physicians rate disease activity in SLE differently. Physicians appear to place more emphasis on laboratory features while patients place more emphasis on function.

Cited by 90 publications

References 15 publications

Ethnic disparities in patients with systemic lupus erythematosus

Ethnic disparities in patients with systemic lupus erythematosus

Depression and Quality of Life in Patients with Systemic Lupus Erythematosus

Treatment of Lupus: Impact on Quality of Life

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