Does higher quality of care in systemic lupus erythematosus translate to better patient outcomes?

Purpose: To assess if high quality of care (QOC) in SLE results in improved outcomes of quality of life (QOL) and non-routine health care utilization (HCU).

Methods: One hundred and forty consecutive SLE patients were recruited from the Rheumatology clinic at an academic center. Data on QOC and QOL were collected along with demographics, socio-economic, and disease characteristics at baseline.

Does Higher Quality of Care in Systemic Lupus Erythematosus Improve Quality of Life?

Objective: To study the association between high quality of care (QOC) and quality of life (QOL) and nonroutine health care use (HCU) in systemic lupus erythematosus.

Methods: Data were derived from 814 participants from the Lupus Outcomes Study sample. Data on sociodemographic information, disease status, medications, and health care variables were collected through annual interviews.

Ulcerative cutaneous sarcoidosis successfully treated with infliximab.

Sarcoidosis is a systemic inflammatory disorder with cutaneous involvement present in 25% of cases. We present a patient with ulcerative sarcoidosis to highlight this unusual presentation of a relatively rare cutaneous condition that was treated successfully using infliximab. The drug is effective in cutaneous sarcoidosis, but relapses can occur after discontinuation.

Pneumococcal Vaccination Among Lupus Patients: Who Are the Recipients?

Purpose: Pneumococcal vaccination (PV) is indicated for the elderly (age ≥65 years) and those with chronic disease or who are immunosuppressed. We aimed to study the rate and predictors of recommendation/receipt of 23 valent pneumococcal polysaccharide vaccine (PPSV23) in immunosuppressed systemic lupus erythematosus (SLE) patients.

Methods: Data were obtained through self-report questionnaires and medical chart review of 150 SLE patients.

Drivers of Satisfaction With Care for Patients With Lupus.

Objective: Quality of life (QOL) and quality of care (QOC) in systemic lupus erythematosus (SLE) remains poor. Satisfaction with care (SC), a QOC surrogate, correlates with health behaviors and outcomes. This study aimed to determine correlates of SC in SLE.

Sleep Disturbance and Depression Symptoms Mediate Relationship Between Pain and Cognitive Dysfunction in Lupus.

Objective: To determine whether sleep disturbance and symptoms of depression mediate the relationship between pain and cognitive dysfunction (CD) in a sample of 115 patients with systemic lupus erythematosus (SLE).

Methods: A total of 115 patients with SLE completed questionnaires regarding pain, perceived stress, depression, sleep, and CD. Relationships among pain, sleep, depression, and CD were assessed using bootstrap mediation models, controlling for race/ethnicity, fibromyalgia diagnosis, current corticosteroid use, disease activity and damage, and perceived stress.

Sex Differences in Quality of Life in Patients With Systemic Lupus Erythematosus.

Objective: Systemic lupus erythematosus (SLE) predominantly affects women. Clinical phenotype and outcomes in SLE may vary by sex and are further complicated by unique concerns that are dependent upon sex-defined roles. We aimed to describe sex differences in disease-specific quality of life (QoL) assessment scores using the Lupus Patient-Reported Outcome (LupusPRO) tool in a large international study.

Does Systemic Lupus Erythematosus Care Provided in a Lupus Clinic Result in Higher Quality of Care Than That Provided in a General Rheumatology Clinic?

Objective: To compare the quality of care received by patients with systemic lupus erythematosus (SLE) in 2 settings within the academic institution (a dedicated lupus clinic and a general rheumatology clinic) using validated SLE quality measures.

Methods: One hundred fifty consenting, consecutive SLE patients receiving longitudinal care at the Rush University general rheumatology clinic (n = 73) or the subspecialty lupus clinic (n = 77) were recruited. An updated quality measure survey and retrospective medical chart review were used to evaluate each quality measure (n = 20).

Validation of SIMPLE Index for Lupus Disease Activity.

Objective: An easy, quick tool requiring minimal training or health care provider input would potentially have greater uptake for clinical use among rheumatologists and primary care physicians for assessment of disease activity in systemic lupus erythematosus (SLE). SIMPLE (SIMple Disease Assessment for People with Lupus Erythematosus) index is a composite numeric tool that is easy and quick to calculate. We prospectively assessed the performance of the SIMPLE index as a disease activity surrogate against physician-based disease activity measures.

Validation of the LupusPRO version 1.8: an update to a disease-specific patient-reported outcome tool for systemic lupus erythematosus.

Objectives LupusPRO has shown good measurement properties as a disease-specific patient-reported outcome tool in systemic lupus erythematosus (SLE). For the purpose of clinical trials, the version 1.7 (v1.

Practice patterns in longitudinal lupus care provision: patient and physician perspectives.

Background/purpose To plan a quality improvement project, we need to understand the practice patterns of physicians. We undertook an online survey of systemic lupus erythematosus (SLE) patients and physicians providing care to SLE patients to determine the patterns of medical care provided to SLE patients. Materials and methods Two self-report surveys were developed.

SLE and Non-Hodgkin's Lymphoma: A Case Series and Review of the Literature.

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder punctuated by varied multiorgan complications all along the course of its natural history. Lymphoma represents a relatively well-recognized malignant phenomenon associated with lupus. The cause and effect relationships of lymphoma in SLE have been subject to extensive scrutiny with several studies reporting on clinic-pathologic characteristics and risk factors predicting lymphoma development in SLE.

Serum free light chains, interferon-alpha, and interleukins in systemic lupus erythematosus.

Objective: Interleukin-6 (IL-6), interleukin-10 (IL-10), interferon-alpha (IFN-α), and free light chains (FLCs: lambda, kappa) have all been noted to be of importance in systemic lupus erythematosus (SLE). Herein, we quantified and explored the relationship between these inflammatory mediators and disease activity in SLE; and stratified by their current anti-dsDNA antibody status.

Methods: Seventy-seven SLE patients underwent assessment of disease activity using the SLE disease activity index (SLEDAI).

Posterior reversible encephalopathy syndrome in systemic lupus erythematosus.

Background/objective: Posterior reversible encephalopathy syndrome (PRES) is an underrecognized and reversible condition in systemic lupus erythematosus (SLE) that could mimic neuropsychiatric lupus. Identification of any distinct clinical patterns is important as one would need to escalate rather than decrease or discontinue immune suppression in neuropsychiatric lupus.

Methods: We retrospectively identified and described 5 patients with SLE who were hospitalized and diagnosed with PRES from 2008 to 2013 in a tertiary medical center and reviewed relevant literature.

Validation of the Cutaneous Lupus Disease Area and Severity Index (CLASI) using physician- and patient-assessed health outcome measures.

Background: The Cutaneous Lupus Disease Area and Severity Index (CLASI) has not been validated using rheumatologist-conducted disease activity and damage assessments, especially cutaneous assessments. Active skin disease and skin damage may have substantial effects on patient-reported outcomes and on body image.

Objective: We sought to validate the CLASI against: (1) physician-assessed disease activity and damage measures; and (2) patient-reported assessment of quality of life and body image.

Disease-specific patient reported outcome tools for systemic lupus erythematosus.

Purpose: Systemic lupus erythematosus (SLE) can significantly affect both health and non-health-related quality of life (HRQOL and non-HRQOL). However, of the existent published patient-reported outcome (PRO) tools, none were developed from US patients, an ethnically diverse population. Furthermore, these tools do not address men with SLE or assess non-HRQOL issues.

Rheumatologists' quality of care for lupus: comparison study between a university and county hospital.

Objective: Quality of care received from physicians may impact health outcomes in systemic lupus erythematosus (SLE). We compared physician quality of care (P-QOC), health-related quality of life (HRQOL), and disease activity and damage between SLE patients receiving outpatient care at a university and a county rheumatology clinic.

Methods: Forty-two university and 41 county clinic SLE patients provided data on 5 P-QOC parameters and HRQOL health outcomes (Short Form 36 [SF-36] health survey and EuroQol 5-domain instrument [EQ-5D]).

A brief assessment tool for body image in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) may adversely affect body image in multitude ways. Development and validation of a brief and valid SLE specific body image tool were undertaken. Eleven items were identified on interview of 21 SLE patients for the Body Image Lupus Scale (BILS v1.

Treatment of lupus: impact on quality of life.

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.

Body image in patients with systemic lupus erythematosus.

Background: Systemic lupus erythematosus (SLE), a multisystemic disease of young women may be disfiguring and affect physical and emotional health. Body image literature in SLE is scant and controversial.

Purpose: We compared body image-related quality of life in subjects with (n = 87) and without (n = 78) SLE and determined its correlates using the body image quality of life inventory (BIQLI).

Serum free light chains as biomarkers for systemic lupus erythematosus disease activity.

Objective: To evaluate serum free light chains (FLC) as a putative biomarker of systemic lupus erythematosus (SLE) activity.

Methods: Seventy-five SLE patients and 41 age- and sex-matched rheumatoid arthritis (RA) controls were enrolled. Disease activity was assessed using the Safety of Estrogens in Lupus Erythematosus: National Assessment version of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) definition and physician global assessments for SLE and the Disease Activity Score in 28 joints for RA.

LupusQoL-US benchmarks for US patients with systemic lupus erythematosus.

Objective: The LupusQoL-US instrument was recently validated in the US. We studied the benchmarks for a US patient cohort with systemic lupus erythematosus (SLE) and relevant demographic and disease correlates.

Methods: LupusQoL-US was administered to 185 patients with SLE.