Patient and Physician Perspectives of Systemic Lupus Erythematosus Flare: A Qualitative Study

作者：Jennifer L Rogers, Megan E. B. Clowse, Kevin McKenna, Summer Starling, Teresa Swezey, Nneka Molokwu, Amy Corneli, David S. Pisetsky, Kai Sun, Lisa Criscione‐Schreiber, Rebecca E. Sadun, Mithu Maheswaranathan, Dana Burshell, Jayanth Doss, Amanda M. Eudy · 发表于：The Journal of Rheumatology · 年份：2023 · DOI：10.3899/jrheum.2023-0721 · 被引用次数：14 · 研究领域：Systemic Lupus Erythematosus Research、Rheumatoid Arthritis Research and Therapies、Cytomegalovirus and herpesvirus research

OBJECTIVE: Systemic lupus erythematosus (SLE) flares are associated with increased damage and decreased health-related quality of life. We hypothesized that there is discordance between physicians' and patients' views of SLE flare. In this study, we aimed to explore patient and physician descriptions of SLE flares. METHODS: We conducted a qualitative descriptive study using in-depth interviews with a purposeful sample of patients with SLE (who met 1997 American College of Rheumatology or Systemic Lupus International Collaborating Clinics criteria) and practicing rheumatologists. Interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis. RESULTS: Forty-two patient participants with SLE, representing a range of SLE activity, completed interviews. The majority described flare symptoms as joint pain, fatigue, and skin issues lasting several days. Few included objective signs or laboratory measures, when available, as features of flare. We interviewed 13 rheumatologists from 10 academic and 3 community settings. The majority defined flare as increased or worsening SLE disease activity, with slightly more than half requiring objective findings. Around half of the rheumatologists included fatigue, pain, or other patient-reported symptoms. CONCLUSION: Patients and physicians described flare differently. Participants with SLE perceived flares as several days of fatigue, pain, and skin issues. Providers defined flares as periods of increased clinical SLE...