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Patient-reported outcome measures in a population of medically indigent patients with systemic lupus erythematosus in Puerto Rico
被引:2
作者:
Rodriguez-Rivera, Diana V.
[1
]
Rodriguez-Navedo, Yerania
[1
]
Nieves-Plaza, Mariely
[2
]
Vila, Luis M.
[1
]
机构:
[1] Univ Puerto Rico, Div Rheumatol, Dept Med, Med Sci Campus,POB 365067, San Juan, PR 00936 USA
[2] San Juan Bautista Sch Med, Grad Programs, Caguas, PR USA
来源:
SAGE OPEN MEDICINE
|
2016年
/
4卷
关键词:
Systemic lupus erythematosus;
patient-reported outcomes;
quality of life;
underserved population;
Puerto Rico;
D O I:
10.1177/2050312116670927
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Objective: To determine patient-reported outcomes measures in indigent patients with systemic lupus erythematosus receiving their healthcare through the Puerto Rico government managed care system and compare these measures with non-indigent patients treated in a private fee-for-service setting. Methods: A cross-sectional study was conducted in a cohort of 98 Puerto Ricans with systemic lupus erythematosus. Patients from the public group (n = 40) were treated in a university-based specialized systemic lupus erythematosus clinic and the private group (n = 58) in a community-based rheumatology practice. Demographic and clinical features and patient-reported outcomes measures per LupusPRO instrument were determined. LupusPRO captures quality-of-life measures in 12 domains. Differences among study groups were examined using chi-square, Fisher's exact, t-tests, and the Wilcoxon signed-rank test. Results: The mean (standard deviation) age of the study population was 44.9 (12.0) years; 94 (95.9%) were women. Patients in the public setting were younger and were more likely to have renal disease and elevated anti-double-stranded DNA antibodies, and being treated with azathioprine and cyclophosphamide. Patients from the public sector were more likely to have better quality-of-life measures in the LupusPRO domains of pain/vitality and coping. No significant differences were observed for the domains of lupus symptoms, physical health, emotional health, body image, cognition, procreation, lupus medications, desires/goals, social support, and satisfaction with medical care. Conclusion: Despite having a lower socioeconomic status and worse clinical status, systemic lupus erythematosus patients from the public sector had equal or better patient-reported outcomes measures than those treated in the private setting. This favorable outcome may be associated with the comprehensive healthcare received by these patients in a specialized lupus clinic.
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