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Satisfaction with control of systemic lupus erythematosus and lupus nephritis: physician and patient perspectives

Authors Mozaffarian N, Lobosco S, Lu P, Roughley A, Alperovich G

Received 30 April 2016

Accepted for publication 13 August 2016

Published 4 October 2016 Volume 2016:10 Pages 2051—2061

DOI https://doi.org/10.2147/PPA.S111725

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Johnny Chen

Neelufar Mozaffarian,1 Steve Lobosco,2 Peng Lu,3 Adam Roughley,2 Gabriela Alperovich4

1Clinical Development, AbbVie Inc., North Chicago, USA; 2Adelphi Real World Ltd., Macclesfield, UK; 3Clinical Development, AbbVie Inc., Worcester, MA, USA; 4Global Medical Affairs Immunology, AbbVie Inc., Madrid, Spain

Purpose: Patient satisfaction with disease control of systemic lupus erythematosus (SLE) is an important component of medical management. This analysis evaluated patient and physician satisfaction with disease control of SLE, factors associated with satisfaction/dissatisfaction, and the degree of physician–patient concordance of these parameters.
Patients and methods: Data were extracted from the US Adelphi Real World Lupus Disease Specific Programme®, a cross-sectional survey of 50 rheumatologists, 25 nephrologists, and their patients with non-nephritis SLE (NNSLE) or lupus nephritis (LN).
Results: Physicians reported moderate or severe disease activity in 25.0% of patients with NNSLE and in 50.5% of patients with LN, and were satisfied with disease control in 78.6% (132/168) and 73.8% (152/206) of patients, respectively. For patients, 75.8% (75/99) with NNSLE were satisfied with their current treatment, compared with 65.5% (74/113) with LN. Physician–patient agreement (70.7%) on the level of satisfaction was “slight” (kappa =0.1445) for NNSLE; patients were more frequently dissatisfied than physicians with regard to joint tenderness, fatigue, anxiety, pain on movement, malar rash, and photosensitivity. Physician–patient agreement (71.4%) on the level of satisfaction was “fair” (kappa =0.3695) for LN; patients expressed greater dissatisfaction than physicians for headache, photosensitivity, and anxiety, whereas physicians were more dissatisfied with regard to joint swelling, kidney function, and blood pressure control. In general, patients with NNSLE or LN who were dissatisfied (or whose physicians were dissatisfied) were more likely to have joint swelling, joint stiffness, malar rash, hair loss, depression, and fatigue, have moderate or severe disease, or to be currently experiencing disease flare.
Conclusion: These data highlight the patient and physician dissatisfaction with real-world disease control of SLE.

Keywords: lupus, satisfaction, concordance, agreement, disease control

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