Arora Shilpa, Block Joel A, Nika Ailda, Sequeira Winston, Katz Patricia, Jolly Meenakshi
Department of Rheumatology, Rush University Medical Center, Chicago, IL, USA.
Department of Rheumatology, University of California, San Francisco, CA, USA.
Lupus. 2023 May;32(6):771-780. doi: 10.1177/09612033231172664. Epub 2023 Apr 25.
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).
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. LupusPRO assessing health-related (HR) QOL and non (N)HRQOL was utilized. Follow up QOL and HCU were collected prospectively at 6 months. High QOC was defined as those meeting ≥80% of the eligible quality indicators. Univariate and multivariate regression analyses were performed with QOC and high QOC as independent variables and HRQOL and NHRQOL as dependent variables at baseline and follow up. Multivariable models were adjusted for demographics and disease characteristics. Secondary outcomes included non-routine HCU and disease activity at follow up.
Baseline and follow up data on 140 and 94 patients, respectively, were analyzed. Mean (SD) performance rate (QOC) was 78.6 (13.4) with 52% patients in the high QOC group. QOC was associated with better NHRQOL at baseline and follow up but not with HRQOL. Of all the NHRQOL domains, QOC was positively associated with treatment satisfaction. QOC or high QOC were not associated with non-routine HCU and were instead associated with higher disease activity at follow up.
Higher QOC predicted better NHRQOL by directly impacting treatment satisfaction in SLE patients in this cohort. Higher QOC, however, was not associated with HRQOL, HCU, or improvement in disease activity at follow up.
评估系统性红斑狼疮（SLE）的高质量护理（QOC）是否能改善生活质量（QOL）和非常规医疗保健利用（HCU）的结果。
从一个学术中心的风湿病诊所招募了140例连续的SLE患者。在基线时收集了有关QOC和QOL的数据以及人口统计学、社会经济和疾病特征。使用LupusPRO评估与健康相关的（HR）QOL和非（N）HRQOL。前瞻性地在6个月时收集随访QOL和HCU。高QOC定义为符合≥80%合格质量指标的患者。在基线和随访时，以QOC和高QOC作为自变量，HRQOL和NHRQOL作为因变量进行单变量和多变量回归分析。多变量模型针对人口统计学和疾病特征进行了调整。次要结果包括随访时的非常规HCU和疾病活动度。
分别分析了140例和94例患者的基线和随访数据。平均（标准差）绩效率（QOC）为78.6（13.4），高QOC组患者占52%。QOC在基线和随访时与更好的NHRQOL相关，但与HRQOL无关。在所有NHRQOL领域中，QOC与治疗满意度呈正相关。QOC或高QOC与非常规HCU无关，反而与随访时更高的疾病活动度相关。
在该队列中，较高的QOC通过直接影响SLE患者的治疗满意度来预测更好的NHRQOL。然而，较高的QOC与HRQOL、HCU或随访时疾病活动度的改善无关。
