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Lupus. 2018 Mar;27(3):501-506. doi: 10.1177/0961203317722412. Epub 2017 Aug 1.

Discordance of patient and physician health status concerns in systemic lupus erythematosus.

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1 School of Clinical Sciences, Monash University, Australia.
2 Department of Rheumatology, Monash Health, Clayton, Australia.
3 Alfred Health, Melbourne, Australia.


Objectives To compare the health status concerns of patients with systemic lupus erythematosus (SLE) and of their physicians. Methods Cross-sectional questionnaire study of SLE patients and their treating physicians at a tertiary disease-specific outpatient clinic. Patients and physicians completed a questionnaire regarding their concern about specific disease manifestations and impact on quality of life. For each item, degree of concern was rated on a five-point Likert scale and summarized as median (interquartile range). Ratings between patients and physicians were compared using Mann-Whitney U tests. Results A total of 84 patients and 21 physicians participated. Patients' predominant concerns centred on function and fatigue, whereas physicians' concerns focused on SLE-related organ complications. Of the 10 highest ranked patient concerns, only two were common to the 10 highest ranked physician concerns, while physicians rated seven significantly differently; all 10 highest ranked physician concerns were rated significantly lower by patients. The three highest ranked patient concerns (fatigue, pain and feeling worn out) were routinely assessed by 47.6%, 42.9% and 9.5% of physicians, respectively. Conclusion There was significant discordance between SLE patient and physician health status concerns. Items which were ranked highly by patients were not assessed consistently by physicians, highlighting a significant gap in healthcare communication.


Discordance; fatigue; pain; patient-reported outcomes; quality of life; unmet needs

[Indexed for MEDLINE]

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