Patient- and Physician-reported Satisfaction With Systemic Lupus Erythematosus Treatment in US Clinical Practice

• Published in: Clinical therapeutics 2017-09, Vol.39 (9), p.1811-1826
• Main Authors: Pascoe, Katie, Lobosco, Steve, Bell, David, Hoskin, Ben, Chang, David J., Pobiner, Bonnie, Ramachandran, Sulabha
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized - therapeutic use; Arthritis; Autoimmune diseases; belimumab; Chronic conditions; Clinical medicine; Cross-Sectional Studies; Fatigue; Fatigue - drug therapy; Female; Humans; Immunosuppressive agents; Immunosuppressive Agents - therapeutic use; Lupus; Lupus Erythematosus, Systemic - drug therapy; Male; Medical personnel; Middle Aged; Monoclonal antibodies; Odds Ratio; Pain - drug therapy; Patient Satisfaction; Patients; Personal Satisfaction; Physicians; Quality of life; Studies; Surveys and Questionnaires; Systemic lupus erythematosus; Treatment Outcome; treatment satisfaction; United States; Variables; Workloads; Young Adult
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/j.clinthera.2017.07.039

This two-part study comprised two descriptive, cross-sectional surveys to evaluate treatment satisfaction among patients with systemic lupus erythematosus (SLE) and their physicians from US clinical practices. The Lupus Plus Project (LPP; part one) involved belimumab-containing regimens; the Disease Specific Program (DSP; part two) included all treatments and was designed to build on the body of evidence from part one. The LPP recruited patients receiving belimumab, and comprised 2 paper questionnaires: a patient self-completion questionnaire (PSC) and a patient record form (PRF) completed by the physician. The DSP enrolled patients with SLE receiving any treatment and comprised four parts: a PSC, a PRF completed by the physician after patient consultation, face-to-face physician interviews, and a workload form completed by the physicians to indicate their total SLE patient workload. The key objective of this study was to assess physician and patient satisfaction with current treatment. From the PSCs, data regarding patient-reported satisfaction with current treatment were available for 263 patients who were receiving belimumab combination therapy (LPP) and 250 patients who were receiving non-belimumab treatment (DSP). The majority of patients (belimumab, 86.3% [227/263]; non-belimumab, 78.4% [196/250]) responded positively (at least “somewhat satisfied”) when asked about current treatment satisfaction, as did physicians (belimumab, 82.9% [311/375]; non-belimumab, 74.3% [326/439]). In multivariate analysis, factors most strongly associated with patient-reported satisfaction for patients receiving belimumab were patient-reported improvements in leisure activities since taking belimumab (odds ratio [OR] = 4.66), physician-reported improvements in fatigue (OR = 3.72), patient-reported improvements in general symptoms (OR = 3.02), and pain/achiness (OR = 2.71). Physician satisfaction was associated with clinical outcome such as improvements in pain/achiness (OR = 6.16), fatigue (OR = 3.76), and patient-reported satisfaction with treatment frequency (OR = 3.91). In patients receiving other SLE treatments, dosing frequency of current treatment (OR = 3.64) and a reduction in fatigue severity (OR = 3.61) were most strongly associated with patient-reported satisfaction; physician satisfaction was most strongly associated with a reduction in fatigue (OR = 6.22) and current remission status (OR = 6.05). When considering SLE treatment satisfaction patients tend to con