Acceptability and impact of a lifestyle intervention for systemic lupus erythematosus: Qualitative analysis of living well with lupus study

Despite the beneficial effects of a healthier lifestyle, lack of more robust data hampers standardization of recommendations for patients with systemic lupus erythematosus (SLE). Thus, this study explores the experiences, perceptions, and health effects of a newly developed healthy lifestyle intervention in patients with SLE. This was a qualitative, descriptive study using focus group discussions with SLE patients with high cardiovascular risk who participated in a 6-month behavioral lifestyle intervention versus standard of care randomized controlled trial. The intervention group received the Living Well with Lupus (LWWL) program aimed at changing lifestyle behaviors. Focus groups were composed of 4-6 LWWL participants each. Deductive and inductive qualitative content analysis was performed using the MAXQDA data management software. A thematic analysis was conducted wherein thick descriptions of key themes around SLE patients' perceptions related to the intervention and interventions' effects on routine, health-related outcomes and well-being were developed. 19 patients participated in the focus groups (age: 42 +/- 7 years; BMI: 28.3 +/- 2.4 kg/m2; mild disease activity and organ damage index). Overall, (a) participants were mostly positive about the intervention components, although views of home-based exercise and food diaries were both positive and negatives; (b) barriers and facilitators to intervention adherence included socioeconomic, environmental and individual factors; (c) new behaviors and knowledge were achieved, which participants intended to maintain after the study; and (d) the intervention positively impacted daily functioning, physical and mental health, and overall wellbeing. LWWL participants reported success in achieving healthy lifestyle behaviors in addition to improvements in perceived physical and mental health and overall wellbeing during the LWWL program. Results of this qualitative assessment, including an overview of barriers and facilitators to program initiation and adherence, should guide future research on the implementation of lifestyle interventions in SLE care.Clinicaltrials.gov NCT04431167.