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Mousavi SM, Bagheri SM, Jalali Heris N, Matbouraftar P, Azarian M, Kordbagheri M. Structural equation modeling to estimate treatment adherence based on the light triad of personality and sense of coherence in patients with type-2 diabetes: examining the mediating role of psychological well-being. Front Psychol 2023; 14:1285808. [PMID: 38090178 PMCID: PMC10711286 DOI: 10.3389/fpsyg.2023.1285808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/13/2023] [Indexed: 02/20/2024] Open
Abstract
Background The current study investigated the relationship between the light triad of personality and self-coherence with treatment adherence in patients with Type 2 Diabetes Mellitus (T2DM) using Structural Equation Modeling (SEM). Psychological well-being was considered a mediator variable in this SEM assessment. Method A cross-sectional study by convenience sampling was conducted, and 368 patients with T2DM were recruited from 10 private practice and general hospitals from May to November 2021 in Gilan province, Iran. The Reef's Psychological Well-being Questionnaire, the Light Triad Rating Scale, and Antonovsky's Sense of Coherence Scale were used for data collection. Structural equation modeling was used to examine the model fitness and identify direct/indirect relationships among variables. Data were analyzed by the SPSS (Version 26) and AMOS software (Version 24). Results The average score of light triads, sense of coherence, psychological well-being, and treatment adherence were 70.36 ± 25.55, 108.25 ± 37.68, 57.03 ± 23.84, and 106.81 ± 39.61, respectively. Model fit statistics suggest that the measurement model fits the data well: χ2 (146, N = 368) = 314.011 (p < 0.001). The SEM results showed that the light triad of personality (β = 0.12) and self-coherence (β = 0.14) were positively associated with treatment adherence. Anxiety, the light triad of personality (β = 0.12), and self-coherence (β = 0.14) affect treatment adherence indirectly through psychological well-being. Conclusion The analysis of the SEM revealed that the suggested model had a suitable goodness of fit. So, using self-coherence and psychological well-being structures in designing interventional programs is recommended to optimize treatment adherence in patients with T2DM.
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Affiliation(s)
| | | | | | | | - Mozhdeh Azarian
- Department of Nursing and Midwifery, Rasht Branch, Islamic Azad University, Rasht, Iran
| | - Mohammadreza Kordbagheri
- Department of Statistics, Faculty of Mathematical Sciences, Shahid Beheshti University, Tehran, Iran
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Aguilar-Latorre A, Asensio-Martínez Á, Oliván-Blázquez B, Álvarez-Bueno C, Cavero-Redondo I, Lionis C, Symvoulakis EK, Magallón-Botaya R. Association between sense of coherence and depression in patients with chronic pain: A systematic review and meta-analysis. PLoS One 2023; 18:e0279959. [PMID: 36630397 PMCID: PMC9833581 DOI: 10.1371/journal.pone.0279959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chronic pain is a common complaint having distressing consequences for those that suffer from it. Pain and depression concur within the context of comorbidity, and both share underlying stress conditions. Sense of coherence (SOC) is a factor that determines how well an individual manages stress and stays healthy. Its relationship with depression has been frequently reported in the literature. Our objective was to assess the amount of evidence available regarding the association between SOC and depression in patients suffering from chronic pain. METHODS A systematic review and meta-analysis were performed. Searches were conducted between November 01 and December 31, 2020 in PubMed, Web of Science, Embase, PsycINFO, Psicodoc, ScienceDirect and Dialnet. There were no restrictions regarding the date of publication of the study. Evidence related to the relationship between SOC and depression in patients with chronic pain was summarized and compared. RESULTS A total of 163 articles were identified. We included 9 papers in the qualitative and quantitative synthesis. The pooled correlation coefficient was -0.55 (95%: -0.70; -0.41) and was not modified after removing any study. The heterogeneity across the studies was considerable (I2 = 94.8%; p < 0.001). The random-effects meta-regression models for the association between SOC and depression showed that age (p = 0.148) and percentage of women (p = 0.307) were not related to heterogeneity across studies. No publication bias was detected (p = 0.720). CONCLUSIONS At first glance, the included studies give the impression that SOC is an important factor in depression levels of patients with chronic pain. Most of the included studies revealed a moderate association between SOC and depressive symptoms.
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Affiliation(s)
- Alejandra Aguilar-Latorre
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain
| | - Ángela Asensio-Martínez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- * E-mail:
| | - Celia Álvarez-Bueno
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Iván Cavero-Redondo
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Christos Lionis
- Clinic of Social and Family Medicine (CSFM), School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Emmanouil K. Symvoulakis
- Clinic of Social and Family Medicine (CSFM), School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Rosa Magallón-Botaya
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS, RD21/0016/0005), Carlos III Health Institute, Madrid, Spain
- Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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Campos-Guzmán J, Valdez-López M, Govea-Peláez S, Aguirre-Aguilar E, Perez-Garcia LF, van Mulligen E, Castillejos-Molina R, Barrera-Vargas A, Merayo-Chalico J. Determinants of sexual function in male patients with systemic lupus erythematosus. Lupus 2022; 31:1211-1217. [PMID: 35702930 DOI: 10.1177/09612033221107802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Our study aims to describe the association between SLE and sexual function, analysing demographic variables, comorbidities and other disease-related factors. As an exploratory objective, the impact of asking about sexual function during outpatient consultation was evaluated. METHODS From 2018 to 2019, we invited sexually active men diagnosed with SLE to complete questionnaires that evaluated their sexual function and quality of life. Additionally, patients were asked if they believed they had sexual dysfunction, whether they would be interested in receiving specialized sexual care, and if they considered SLE to be detrimental to their sexual function. Epidemiological and disease-related data were retrieved from the patients' clinical records. RESULTS We included 124 men with SLE. Twenty-two (18%) patients answered positively when asked if they believed they had sexual dysfunction. These patients had lower overall erectile function scores and lower physical function scores than those who did not consider they had sexual dysfunction. In the multivariable analysis, factors that were associated with better sexual function were high physical function (B = 0.126, p = .031), lower BMI (B = 0.53, p = .010) and the patient's perception of normal sexual function (B = 13.0, p < .001). Comorbidities associated with worse sexual function were type 2 diabetes (B = -8.1, p = .017) and a history of thrombosis (B = -5.12, p = .019). CONCLUSION Sexual function of male patients with SLE is impaired, independently of disease activity, chronic disease damage or pharmacological treatment. A simple question about perception of sexual function in the outpatient clinic can be used to help determine which patients could benefit from a multidisciplinary intervention to improve sexual health.
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Affiliation(s)
- Jonathan Campos-Guzmán
- Department of Immunology and Rheumatology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
| | - Martín Valdez-López
- Department of Immunology and Rheumatology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
| | - Samuel Govea-Peláez
- Department of Immunology and Rheumatology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
| | - Eduardo Aguirre-Aguilar
- Department of Immunology and Rheumatology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
| | - Luis F Perez-Garcia
- Department of Rheumatology, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Elise van Mulligen
- Department of Rheumatology, 6993Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ricardo Castillejos-Molina
- Department of Urology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
| | - Ana Barrera-Vargas
- Department of Immunology and Rheumatology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
| | - Javier Merayo-Chalico
- Department of Immunology and Rheumatology, 42559Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico
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4
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Pirri S, Talarico R, Marinello D, Turchetti G, Mosca M. A systematic literature review of existing tools used to assess medication adherence in connective tissue diseases: the state of the art for the future development of co-designed measurement tools. Reumatismo 2021; 73. [PMID: 34814655 DOI: 10.4081/reumatismo.2021.1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022] Open
Abstract
Lack of medication adherence is frequent in chronic connective tissue diseases and is associated with poorer health outcomes, low quality of life and economic loss. This research is based on a systematic literature search and aims to identify the surveys and tools used for the assessment of medication adherence in patients with connective tissue diseases (CTDs) and in particular the tools co-designed with patients. A systematic literature review was performed in PubMed and Embase databases searching for studies concerning the application of surveys or tools designed for medication adherence assessment. A specific analysis was also performed to identify which of these existing tools were developed in co-design with patients affected by CTDs. 1958 references were identified, and 31 studies were finally included. Systemic lupus erythematosus was the most investigated disease, followed by the Behçet's disease. The tools used to assess adherence in CTDs were, in most cases, valid and useful. However, the results showed a certain degree of heterogeneity among the studies and the medication adherence assessment and measurement tools adopted, which were mostly based on selfreported questionnaire. No co-designed tools with patients were found. Low- and non-adherence were explored in some CTDs with valid and useful tools, while other CTDs still need to be assessed. Therefore, more efforts should be made to better understand the specific reasons for the low- and non-adherence in CTDs patients.
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Affiliation(s)
- S Pirri
- Institute of Management, Scuola Superiore Sant'Anna, Pisa.
| | - R Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa.
| | - D Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa.
| | - G Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Pisa.
| | - M Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, Pisa.
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5
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Sumner LA, Olmstead R, Azizoddin DR, Ormseth SR, Draper TL, Ayeroff JR, Zamora-Racaza G, Weisman MH, Nicassio PM. The contributions of socioeconomic status, perceived stress, and depression to disability in adults with systemic lupus erythematosus. Disabil Rehabil 2019; 42:1264-1269. [PMID: 30776317 DOI: 10.1080/09638288.2018.1522550] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose: Psychological and sociodemographic factors contribute to disability in systemic lupus erythematosus. Yet the pathways by which these factors influence disability remain unclear. The objective of this study was to evaluate a model examining socioeconomic status (SES), perceived stress, and depressive symptoms as determinants of lupus-related disability.Methods: The sample included 134 patients receiving treatment at an academic hospital. Structural equation modeling examined the direct and indirect effects of SES (income, education, and subjective social status), perceived stress (Perceived Stress Scale), and depressive symptoms (Hospital Depression Anxiety Scale depression subscale) on disability (Lupus Patient-Reported Outcome measure Physical Health and Pain-Vitality subscales).Results: Structural equation modeling confirmed that the model fit the data well. The SES exerted a direct negative effect on perceived stress (β = -0.40, p < 0.001). In turn, perceived stress predicted higher levels of depression (β = 0.72, p < 0.001), which ultimately contributed to greater disability (β = 0.53, p < 0.001). The influence of SES on disability was indirect (mediated by perceived stress and depression).Conclusions: Findings support the socioeconomic gradient in disability as mediated by perceived stress and depression, such that lower SES contributed to lupus-related disability via perceived stress and depressive symptoms.Implications for RehabilitationLow socioeconomic status, perceived stress, and depression are prognostic factors for the disability in systemic lupus erythematosus.Study findings indicate that perceived stress and depression fully mediate (account for) the negative impact of low socioeconomic status on lupus-related disability.Screening for and addressing psychological distress may enhance management of disability in lupus patients.This research demonstrates the value of a conceptual framework for identifying potentially modifiable risk factors for disability in lupus and other chronic disabling diseases.
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Affiliation(s)
- Lekeisha A Sumner
- Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Richard Olmstead
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Sarah R Ormseth
- Division of Rheumatology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Taylor L Draper
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Julia R Ayeroff
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Department of Psychology, Loma Linda University, Loma Linda, CA, USA
| | - Geraldine Zamora-Racaza
- Post-baccalaureate Premedical Program, University of Southern California, Los Angeles, CA, USA
| | - Michael H Weisman
- Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Perry M Nicassio
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
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6
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Costedoat‐Chalumeau N, Houssiau F, Izmirly P, Guern VL, Navarra S, Jolly M, Ruiz‐Irastorza G, Baron G, Hachulla E, Agmon‐Levin N, Shoenfeld Y, Dall'Ara F, Buyon J, Deligny C, Cervera R, Lazaro E, Bezanahary H, Leroux G, Morel N, Viallard J, Pineau C, Galicier L, Vollenhoven RV, Tincani A, Nguyen H, Gondran G, Zahr N, Pouchot J, Piette J, Petri M, Isenberg D. A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring
SLE
: Assessment by Drug Levels and Self‐Administered Questionnaires. Clin Pharmacol Ther 2018; 106:374-382. [DOI: 10.1002/cpt.1194] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 07/23/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Nathalie Costedoat‐Chalumeau
- Internal Medicine DepartmentCentre de Référence Maladies Auto‐Immunes et Systémiques RaresAP‐HPCochin Hospital Paris France
- Université Paris Descartes‐Sorbonne Paris Cité Paris France
- Center for Epidemiology and StatisticsINSERM U 1153Sorbonne Paris Cité (CRESS) Paris France
| | - Frédéric Houssiau
- Service de RhumatologieCliniques Universitaires Saint‐LucPôle de Pathologies Rhumatismales Inflammatoires et SystémiquesUniversité catholique de Louvain Brussels Belgium
| | - Peter Izmirly
- Division of RheumatologyDepartment of MedicineNew York University School of Medicine New York New York USA
| | - Véronique Le Guern
- Internal Medicine DepartmentCentre de Référence Maladies Auto‐Immunes et Systémiques RaresAP‐HPCochin Hospital Paris France
- Université Paris Descartes‐Sorbonne Paris Cité Paris France
- Center for Epidemiology and StatisticsINSERM U 1153Sorbonne Paris Cité (CRESS) Paris France
| | | | - Meenakshi Jolly
- Rush University Medical CenterRush Lupus Clinic Chicago Illinois USA
| | - Guillermo Ruiz‐Irastorza
- Autoimmune Diseases Research UnitDepartment of Internal MedicineBioCruces Health Research InstituteHospital Universitario CrucesUniversity of the Basque Country Barakaldo Spain
| | - Gabriel Baron
- Centre d'Epidémiologie CliniqueAP‐HPHôpitalHôtel‐DieuUniversité Paris Descartes‐Sorbonne Paris Cité Paris France
| | - Eric Hachulla
- Claude Huriez HospitalInternal Medicine DepartmentCentre de Référence Maladies Auto‐immunes et Systémiques raresUniversité de Lille Lille France
| | - Nancy Agmon‐Levin
- Sheba Medical CenterZabludowicz Center for Autoimmune Diseases Tel‐Hashomer Israel
| | - Yehuda Shoenfeld
- Sheba Medical CenterZabludowicz Center for Autoimmune Diseases Tel‐Hashomer Israel
| | - Francesca Dall'Ara
- Rheumatology and Clinical Immunology UnitSpedali Civili and Department of Clinical and Experimental ScienceUniversity of Brescia Brescia Italy
| | - Jill Buyon
- Division of RheumatologyDepartment of MedicineNew York University School of Medicine New York New York USA
| | - Christophe Deligny
- Internal Medicine DepartmentPierre‐Zobda‐Quitman Hospital Martinique France
| | - Ricard Cervera
- Department of Autoimmune DiseasesHospital Clínic de Barcelona Barcelona Spain
| | | | - Holy Bezanahary
- Internal Medicine DepartmentDupuytren Hospital Limoges France
| | - Gaëlle Leroux
- Internal Medicine DepartmentAP‐HPPitié‐Salpêtrière HospitalUniversité Pierre et Marie Curie Paris France
| | - Nathalie Morel
- Internal Medicine DepartmentCentre de Référence Maladies Auto‐Immunes et Systémiques RaresAP‐HPCochin Hospital Paris France
- Université Paris Descartes‐Sorbonne Paris Cité Paris France
- Center for Epidemiology and StatisticsINSERM U 1153Sorbonne Paris Cité (CRESS) Paris France
| | | | | | - Lionel Galicier
- Clinical Immunology DepartmentAP‐HPSt Louis Hospital Paris France
| | - Ronald Van Vollenhoven
- Department of MedicineUnit for Clinical Research TherapyInflammatory DiseasesKarolinska University Hospital Stockholm Sweden
| | - Angela Tincani
- Rheumatology and Clinical Immunology UnitSpedali Civili and Department of Clinical and Experimental ScienceUniversity of Brescia Brescia Italy
| | - Hanh Nguyen
- Centre for RheumatologyUniversity College London London UK
| | | | - Noel Zahr
- Pharmacology DepartmentAP‐HPHopital Pitié‐Salpêtrière Paris France
| | - Jacques Pouchot
- Internal Medicine DepartmentEuropean Georges Pompidou Hospital Paris France
| | - Jean‐Charles Piette
- Internal Medicine DepartmentAP‐HPPitié‐Salpêtrière HospitalUniversité Pierre et Marie Curie Paris France
| | - Michelle Petri
- Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - David Isenberg
- Centre for RheumatologyUniversity College London London UK
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7
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Sadun RE, Schanberg LE. Transition and transfer of the patient with paediatric-onset lupus: a practical approach for paediatric and adult rheumatology practices. Lupus Sci Med 2018; 5:e000282. [PMID: 30167316 PMCID: PMC6109813 DOI: 10.1136/lupus-2018-000282] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 06/21/2018] [Indexed: 12/14/2022]
Abstract
The prevalence of paediatric-onset SLE (pSLE) is estimated at 1million people worldwide and accounts for a significant proportion of SLE morbidity, mortality and cost. Patients with pSLE are especially vulnerable during and immediately following transfer from paediatric to adult rheumatology care, when substantial delays in care and increased disease activity are common. Transition is the process through which adolescents and young adults (AYA) develop the skills needed to succeed in the adult healthcare environment, a process that typically takes several years and may span a patient's time in paediatric and adult clinics. Recommendations for improving transition and transfer for AYA with pSLE include setting expectations of the AYA patient and family concerning transition and transfer, developing AYA's self-management skills, preparing an individualised transition plan that identifies a date for transfer, transferring at a time of medical and social stability, coordinating communication between the paediatric and adult rheumatologists (inclusive of both a medical summary and key social factors), and identifying a transition coordinator as a point person for care transfer and to monitor the AYA's arrival and retention in adult rheumatology care. Of paramount importance is empowering the adult rheumatologist with skills that enhance rapport with AYA patients, engage AYA patients and families in adult care models, promote adherence and encourage ongoing development of self-management skills.
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Affiliation(s)
- Rebecca E Sadun
- Department of Pediatrics, Division of Rheumatology, Duke Health, Durham, North Carolina, USA
- Department of Medicine, Division of Rheumatology, Duke Health, Durham, North Carolina, USA
| | - Laura E Schanberg
- Department of Pediatrics, Division of Rheumatology, Duke Health, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
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8
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Prados-Moreno S, Sabio JM, Pérez-Mármol JM, Navarrete-Navarrete N, Peralta-Ramírez MI. Adherencia al tratamiento en pacientes con lupus eritematoso sistémico. Med Clin (Barc) 2018; 150:8-15. [DOI: 10.1016/j.medcli.2017.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 05/12/2017] [Accepted: 05/18/2017] [Indexed: 01/30/2023]
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9
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Applyrs DL, Williams EM, Faith TD, Kamen DL, Vazques E, Jurkowski JM. Cultural and quality-of-life considerations when administering corticosteroids as a therapeutic strategy for African American women living with systemic lupus erythematosus. Patient Prefer Adherence 2018; 12:1007-1014. [PMID: 29928116 PMCID: PMC6003291 DOI: 10.2147/ppa.s156457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study investigated the association among corticosteroids, emotional health, physical health, and work/regular activities of daily living in an ethnically diverse sample of women with systemic lupus erythematosus. METHODS A secondary analysis of data from the Medical University of South Carolina Lupus Database was conducted between confirmed cases of lupus (n = 224) and controls (n = 60). The sample comprised 57 Caucasian Americans, 141 Gullah African Americans (a subpopulation of African Americans from the Sea Islands of South Carolina and Georgia), and 86 non-Gullah African Americans. RESULTS Emotional health outcomes were better for women with systemic lupus erythematosus compared with controls. High emotional health scores may be influenced by cultural factors such as masking emotion, disease-coping mechanisms, religion, and strong familial and social support. Although a significant association was not detected between emotional health and work/regular activities of daily living, relationships were significant after adjusting for corticosteroid use. CONCLUSION These findings suggest corticosteroid use does influence the strength of the association between emotional health and work/regular activities of daily living.
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Affiliation(s)
| | - Edith M Williams
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
- Correspondence: Edith M Williams, Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Suite CS303D, Charleston, SC 29425, USA, Tel +1 843 876 1519, Email
| | - Trevor D Faith
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Diane L Kamen
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth Vazques
- Department of Epidemiology and Biostatistics, State University of New York at Albany, One University Place, Rensselaer, NY, USA
| | - Janine M Jurkowski
- Department of Health Policy, Management, and Behavior, State University of New York at Albany, One University Place, Rensselaer, NY, USA
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10
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Almeida FP, Ferreira EAP, Moraes AJPD. Efeitos de Registros de Automonitorização sobre Relatos de Adesão ao Tratamento em Adolescentes com Lúpus. PSICOLOGIA: TEORIA E PESQUISA 2017. [DOI: 10.1590/0102.3772e33412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Descreve-se o estudo realizado com duas adolescentes (P1 e P2) com diagnóstico de lúpus acompanhadas em ambulatório de reumatologia. Investigaram-se os efeitos do uso de registros de automonitorização (RA) e de recordatório 24 horas (R24h) sobre o índice de adesão ao tratamento (IAT) por meio de entrevistas semiestruturadas. P1 foi submetida à sequência R24h-RA e P2, à ordem inversa. Em linha de base, ambas obtiveram valores de IAT abaixo ou igual a 50%. Após intervenção, alcançaram valores acima de 71%, indicando melhora no índice de adesão independentemente da ordem em que os instrumentos foram apresentados. Discute-se o controle do comportamento por regras e a importância da instalação de repertórios de relatos fidedignos sobre comportamentos de adesão ao tratamento do lúpus
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11
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Costedoat-Chalumeau N, Houssiau F, Izmirly P, Le Guern V, Navarra S, Jolly M, Ruiz-Irastorza G, Baron G, Hachulla E, Agmon-Levin N, Shoenfeld Y, Dall'Ara F, Buyon J, Deligny C, Cervera R, Lazaro E, Bezanahary H, Leroux G, Morel N, Viallard JF, Pineau C, Galicier L, Van Vollenhoven R, Tincani A, Nguyen H, Gondran G, Zahr N, Pouchot J, Piette JC, Petri M, Isenberg D. A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring SLE: Assessment by Drug Levels and Self-Administered Questionnaires. Clin Pharmacol Ther 2017; 103:1074-1082. [PMID: 28925027 DOI: 10.1002/cpt.885] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 01/24/2023]
Abstract
Nonadherence to treatment is a major cause of lupus flares. Hydroxychloroquine (HCQ), a major medication in systemic lupus erythematosus, has a long half-life and can be quantified by high-performance liquid chromatography. This international study evaluated nonadherence in 305 lupus patients with flares using drug levels (HCQ <200 ng/ml or undetectable desethylchloroquine), and self-administered questionnaires (MASRI <80% or MMAS-8 <6). Drug levels defined 18.4% of the patients as severely nonadherent. In multivariate analyses, younger age, nonuse of steroids, higher body mass index, and unemployment were associated with nonadherence by drug level. Questionnaires classified 39.9% of patients as nonadherent. Correlations between adherence measured by questionnaires, drug level, and physician assessment were moderate. Both methods probably measured two different patterns of nonadherence: self-administered questionnaires mostly captured relatively infrequently missed tablets, while drug levels identified severe nonadherence (i.e., interruption or erratic tablet intake). The frequency with which physicians miss nonadherence, together with underreporting by patients, suggests that therapeutic drug monitoring is useful in this setting. (Trial registration: ClinicalTrials.gov: NCT01509989.).
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Affiliation(s)
- Nathalie Costedoat-Chalumeau
- AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France; INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | - Frédéric Houssiau
- Service de Rhumatologie, Cliniques Universitaires Saint-Luc; Pôle de Pathologies Rhumatismales Inflammatoires et Systémiques, Université catholique de Louvain, Brussels, Belgium
| | - Peter Izmirly
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, USA
| | - Véronique Le Guern
- AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France; INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | | | - Meenakshi Jolly
- Rush University Medical Center, Rush Lupus Clinic, Chicago, Illinois, USA
| | - Guillermo Ruiz-Irastorza
- Autoimmune Diseases Research Unit, Department of Internal Medicine, BioCruces Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain
| | - Gabriel Baron
- AP-HP, Hôpital Hôtel-Dieu, Centre d'Epidémiologie Clinique, Paris, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Eric Hachulla
- Claude Huriez Hospital, Internal Medicine Department, Centre de Référence Maladies Auto-immunes et Systémiques rares, Université de Lille, Lille, France
| | - Nancy Agmon-Levin
- Sheba Medical Center, Zabludowicz Center for Autoimmune Diseases, Tel-Hashomer, Israel
| | - Yehuda Shoenfeld
- Sheba Medical Center, Zabludowicz Center for Autoimmune Diseases, Tel-Hashomer, Israel
| | - Francesca Dall'Ara
- Rheumatology and Clinical Immunology Unit, Spedali Civili and Dept. of Clinical and Experimental Science-University of Brescia, Italy
| | - Jill Buyon
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, USA
| | - Christophe Deligny
- Pierre-Zobda-Quitman Hospital, Internal Medicine Department, Martinique, France
| | - Ricard Cervera
- Hospital Clínic de Barcelona, Department of Autoimmune Diseases, Barcelona, Spain
| | - Estibaliz Lazaro
- Haut Lévêque Hospital, Internal Medicine Department, Pessac, France
| | - Holy Bezanahary
- Dupuytren Hospital, Internal Medicine Department, Limoges, France
| | - Gaëlle Leroux
- AP-HP, Pitié-Salpêtrière Hospital, Internal Medicine Department, Université Pierre et Marie Curie, Paris, France
| | - Nathalie Morel
- AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares, Paris, France; Université Paris Descartes-Sorbonne Paris Cité, Paris, France; INSERM U 1153, Center for Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Paris, France
| | | | | | - Lionel Galicier
- AP-HP, St Louis Hospital, Clinical Immunology Department, Paris, France
| | - Ronald Van Vollenhoven
- Karolinska University Hospital, Department of Medicine, Unit for Clinical Research Therapy, Inflammatory Diseases, Stockholm, Sweden
| | - Angela Tincani
- Rheumatology and Clinical Immunology Unit, Spedali Civili and Dept. of Clinical and Experimental Science-University of Brescia, Italy
| | - Hanh Nguyen
- University College London, Centre for Rheumatology, London, UK
| | | | - Noel Zahr
- AP-HP, Hopital Pitié-Salpêtrière, Pharmacology Department, Paris, France
| | - Jacques Pouchot
- European Georges Pompidou Hospital, Internal Medicine Department, Paris, France
| | - Jean-Charles Piette
- AP-HP, Pitié-Salpêtrière Hospital, Internal Medicine Department, Université Pierre et Marie Curie, Paris, France
| | - Michelle Petri
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Isenberg
- University College London, Centre for Rheumatology, London, UK
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Zhang L, Lu GH, Ye S, Wu B, Shen Y, Li T. Treatment adherence and disease burden of individuals with rheumatic diseases admitted as outpatients to a large rheumatology center in Shanghai, China. Patient Prefer Adherence 2017; 11:1591-1601. [PMID: 29075106 PMCID: PMC5609799 DOI: 10.2147/ppa.s144624] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE The purpose of this study was to determine treatment adherence and disease burden, analyze detailed medication problems experienced by patients, and identify factors associated with adherence in patients with rheumatic diseases in China. PATIENTS AND METHODS Patients with confirmed diagnoses of ankylosing spondylitis (AS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) were recruited, regardless of demographics, disease severity, and treatment characteristics. Adherence was assessed using the Compliance Questionnaire for Rheumatology and interview-based self-reports. A backwards-stepwise multivariate regression analysis was used to identify factors associated with adherence. RESULTS We collected data on 252 patients who had a rheumatic disease and visited our outpatient clinic in January or February of 2017. There were 121 patients with SLE, 70 with RA, and 61 with AS. The overall adherence rate was 41.7%, with 48.7% for SLE patients, 38.6% for RA patients, and 31.1% for AS patients. The overall EuroQol (EQ)-index was 0.761; AS patients had the best EQ-index (0.792), followed by those with SLE (0.780) and RA (0.700). SLE patients also had greater annual direct costs (US$5,103.58) than RA or AS patients. CONCLUSION Overall, 41.7% of our rheumatic disease patients were adherent to treatment, lower than in many other parts of the world. This indicates that it is important to identify methods that improve adherence in this population. It is particularly important to improve the health status and reduce the disease burden of patients with SLE, the most common of the three rheumatic diseases we analyzed. Our results suggest that reminder tools may improve adherence. Further prospective research is needed to confirm whether reminder tools and other measures can improve patient compliance.
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Affiliation(s)
- Le Zhang
- Department of Pharmacy, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Guo Hong Lu
- Department of Pharmacy, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shuang Ye
- Department of Rheumatology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Bin Wu
- Department of Pharmacy, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yi Shen
- Department of Mathematics, Applied Statistics, Shanghai Jiaotong University, Shanghai, China
| | - Ting Li
- Department of Rheumatology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- Correspondence: Ting Li, Department of Rheumatology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiaotong University, 2000 Jiangyue Road, Shanghai 201112, China, Tel +86 139 1692 7066, Fax +86 21 3450 6151, Email
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Sahebalzamani M, Farahani H, Jamarani MT, Faezi ST, Moradi K, Paragomi P. Effects of a Continuous Care Model on Patients' Knowledge and Health-Related Quality of Life in Systemic Lupus Erythematosus. Rehabil Nurs 2016; 42:E9-E18. [PMID: 27302184 DOI: 10.1002/rnj.283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the effects of applying the continuous care model (CCM) on the knowledge level and health-related quality of life (HRQoL) of systemic lupus erythematosus (SLE) patients and their perceptions of family awareness about the disease. DESIGN The Continuous Care Model (CCM) was implemented for 3 months on 34 SLE patients, in a pretest-posttest quasiexperimental design. METHODS Two sets of questionnaires were designed for knowledge assessment. HRQoL was assessed by SF-36 questionnaires. Analysis was by paired t test and one-way ANOVA. FINDINGS The continuous care model significantly improved patients' knowledge level and their perceptions of their family members' awareness of their disease. HRQoL status in SLE patients was poorer than the general population in six of eight SF-36 scales (p < .05), except for Bodily Pain and Mental Health. Postintervention scores showed improvement in six SF-36 scales (p < .001), except for Bodily Pain and Social Functioning. CONCLUSIONS Our results underlined the advantages of applying the CCM as a comprehensive method of self-care in SLE. CLINICAL RELEVANCE Despite many improvements in SLE care, the patients' quality of life is still much affected by SLE. Implementation of the CCM could lead to improvement in the knowledge and HRQoL of SLE patients.
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Affiliation(s)
- Mohammad Sahebalzamani
- 1 Department of Nursing and Midwifery, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran2 Department of Psychology, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran3 Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Adherence to Oral and Topical Medications in Cutaneous Lupus Erythematosus is not Well Characterized. Dermatol Ther (Heidelb) 2015; 5:91-105. [PMID: 25899142 PMCID: PMC4470959 DOI: 10.1007/s13555-015-0075-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Treatment adherence plays a large role in chronic dermatologic diseases and may play an important role in the outcomes of patients with cutaneous lupus erythematosus (CLE). We sought to gauge what is currently known about adherence to topical and oral medications in patients with CLE. METHODS A review of MEDLINE was performed using a combination of the phrases "adherence", "compliance", "lupus", and "cutaneous". Studies were hand searched and prospective and cross-sectional studies evaluating medication adherence in patients with CLE and systemic lupus erythematosus (SLE) were included. RESULTS Only two articles explored adherence in patients with CLE, while 17 articles discussed treatment adherence in patients with SLE. Depression was consistently cited as detrimental to adherence. The impact that race, ethnicity, and education has on adherence is unclear. Three studies noted a clear connection between adherence and disease activity, while two others did not. Few studies investigated methods that have improved adherence to treatment which have showed promise. CONCLUSION Much of what we know about adherence to medication in patients with lupus is limited to SLE. Although cutaneous symptoms are among the most common manifestations of SLE, cutaneous disease is often managed at least in part with topical agents, and adherence to topical treatment was not assessed in any of the articles, though one study investigated sunscreen usage in patients with CLE. Understanding adherence in patients with CLE may help contribute to better CLE treatment outcomes.
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Beckerman NL, Auerbach C, Kim SJ, Salmon J, Horton R. Lupus (SLE): Existence and Impact of Depressive Symptomatology. SOCIAL WORK IN HEALTH CARE 2015; 54:499-517. [PMID: 26186422 DOI: 10.1080/00981389.2015.1045575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of this cross-sectional study (N = 84) is to: (1) further identify the unique psychosocial challenges facing those living with Systemic Lupus Erythematosus (SLE) and (2) discern the validity of the depression dimension of the System Lupus Erythematosus Needs Questionnaire (SLENQ) (by including the Beck Depression Inventory [BDI-II]). Utilizing the BDI-II, this study replicates and confirms the validity of studies that employed the SLENQ, establishing that those who have manifested signs of depression in the SLENQ, are equally likely to show signs of depression in the BDI-II. Authors identify and confirm that patients who experience SLE-related depression are significantly more likely to forget taking or stop taking their SLE medications. The authors review relevant research, discuss findings, and provide evidence-based recommendations for social workers providing mental health care to patients living with Lupus.
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Kretchy IA, Owusu-Daaku FT, Danquah SA. Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence. Int J Ment Health Syst 2014; 8:25. [PMID: 24987456 PMCID: PMC4077111 DOI: 10.1186/1752-4458-8-25] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/19/2014] [Indexed: 02/01/2023] Open
Abstract
Background Patients with chronic conditions like hypertension may experience many negative emotions which increase their risk for the development of mental health disorders particularly anxiety and depression. For Ghanaian patients with hypertension, the interaction between hypertension and symptoms of anxiety, depression and stress remains largely unexplored. To fill this knowledge gap, the study sought to ascertain the prevalence and role of these negative emotions on anti-hypertensive medication adherence while taking into account patients’ belief systems. Methods The hospital-based cross-sectional study involving 400 hypertensive patients was conducted in two tertiary hospitals in Ghana. Data were gathered on patient’s socio-demographic characteristics, anxiety, depression and stress symptoms, spiritual beliefs, and medication adherence. Results Hypertensive patients experienced symptoms of anxiety (56%), stress (20%) and depression (4%). As a coping mechanism, a significant relation was observed between spiritual beliefs and anxiety (x2 = 13.352, p = 0.010), depression (x2 = 6.205, p = 0.045) and stress (x2 = 14.833, p = 0.001). Stress among patients increased their likelihood of medication non-adherence [odds ratio (OR) = 2.42 (95% CI 1.06 – 5.5), p = 0.035]. Conclusion The study has demonstrated the need for clinicians to pay attention to negative emotions and their role in medication non-adherence. The recommendation is that attention should be directed toward the use of spirituality as a possible mechanism by which negative emotions could be managed among hypertensive patients.
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Affiliation(s)
- Irene A Kretchy
- Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana ; Department of Pharmacy Practice and Clinical Pharmacy, University of Ghana School of Pharmacy, College of Health Sciences, Legon, Ghana
| | - Frances T Owusu-Daaku
- Department of Clinical and Social Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Rivera F, Anaya S. Lupus nephritis flare in young patients: relapse or nonadherence to treatment? Int J Nephrol Renovasc Dis 2014; 7:117-21. [PMID: 24729723 PMCID: PMC3974696 DOI: 10.2147/ijnrd.s58206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose Adherence is a challenging issue in the treatment of systemic lupus erythematosus. Nonadherence has been widely addressed in patients with lupus and must be detected quickly to prevent severe complications. The cases we present illustrate the importance of adherence in young adults. Case 1 A 23-year-old Spanish woman diagnosed with severe lupus nephritis 8 years previously achieved renal remission after immunosuppressive treatment with corticosteroids and cyclophosphamide. Three years later, she developed a renal flare. Her treatment was intensified, and rituximab and mycophenolate mofetil were added. One year later, she was readmitted for a new renal flare. A blood test revealed no detectable levels of mycophenolic acid, and the patient admitted she had not taken her treatment correctly. Treatment was resumed. Four years later, the patient remains in remission. Case 2 A 19-year-old Spanish woman was diagnosed with nephrotic syndrome due to lupus nephritis. She achieved complete remission after treatment with corticosteroids and cyclophosphamide followed by mycophenolate mofetil. Two years later, she developed a severe renal relapse that was treated with corticosteroids, cyclophosphamide, and rituximab. The response to treatment was good. Mycophenolic acid was undetectable in blood. The patient admitted that she had often missed doses before this relapse. The renal response has been maintained since she resumed her previous medications 2 years ago. Conclusion We conclude that the frequent and severe relapses of lupus nephritis observed in young patients may actually be due to nonadherence rather than to refractory disease. Our cases are typical examples of nonadherence that were discovered after a detailed interview with the patients and their families. We emphasize the need for clinical suspicion of nonadherence when caring for young adults with lupus.
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Affiliation(s)
- Francisco Rivera
- Sección de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Sara Anaya
- Sección de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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Williams EM, Ortiz K, Browne T. Social Determinants of Health, the Chronic Care Model, and Systemic Lupus Erythematosus. Int J Chronic Dis 2014; 2014:361792. [PMID: 26464854 PMCID: PMC4590929 DOI: 10.1155/2014/361792] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/09/2013] [Accepted: 12/09/2013] [Indexed: 11/17/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a chronic inflammatory rheumatic disease that disproportionately affects African Americans and other minorities in the USA. Public health attention to SLE has been predominantly epidemiological. To better understand the effects of this cumulative disadvantage and ultimately improve the delivery of care, specifically in the context of SLE, we propose that more research attention to the social determinants of SLE is warranted and more transdisciplinary approaches are necessary to appropriately address identified social determinants of SLE. Further, we suggest drawing from the chronic care model (CCM) for an understanding of how community-level factors may exacerbate disparities explored within social determinant frameworks or facilitate better delivery of care for SLE patients. Grounded in social determinants of health (SDH) frameworks and the CCM, this paper presents issues relative to accessibility to suggest that more transdisciplinary research focused on the role of place could improve care for SLE patients, particularly the most vulnerable patients. It is our hope that this paper will serve as a springboard for future studies to more effectively connect social determinants of health with the chronic care model and thus more comprehensively address adverse health trajectories in SLE and other chronic conditions.
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Affiliation(s)
- Edith M. Williams
- Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 103, Columbia, SC 29210, USA
| | - Kasim Ortiz
- Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, 220 Stoneridge Drive, Suite 103, Columbia, SC 29210, USA
| | - Teri Browne
- College of Social Work, University of South Carolina, Columbia, SC 29208, USA
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Baqai T, Ioannou Y. Comparison of juvenile and adult onset systemic lupus erythematosus. Br J Hosp Med (Lond) 2012; 73:558-63. [DOI: 10.12968/hmed.2012.73.10.558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Yiannis Ioannou
- Clinical Senior Lecturer and Honorary Consultant in Rheumatology in the Centre for Rheumatology Research, Rayne Institute, University College London, London WC1E 6JF
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Resolutive pulmonary endarterectomy in a non-compliant patient with systemic lupus erythematosus and antiphospholipid syndrome. Rheumatol Int 2012; 33:1889-93. [DOI: 10.1007/s00296-011-2346-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 12/20/2011] [Indexed: 11/26/2022]
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Auerbach C, Beckerman NL. Locus of control and lupus: patients' beliefs, perspectives, and disease activity. SOCIAL WORK IN HEALTH CARE 2012; 51:613-626. [PMID: 22905977 DOI: 10.1080/00981389.2012.683685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Patients with lupus often experience a high degree of psychological symptoms such as anxiety, depression, and mood disorders that can influence their beliefs and perceptions of their illness. The purpose of the study was to examine how a patient's self-reported psychosocial needs (depression and anxiety) and beliefs about how much control they have over their health (health locus of control) influences their perception of disease chronicity and acuity. The study findings were based on a survey of 378 patients self-diagnosed with lupus.
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Affiliation(s)
- Charles Auerbach
- Wurzweiler School of Social Work, Yeshiva University, New York, New York 10033, USA.
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