THU0343 How patients ability beliefs about math matter to sle patients disease
Authors: A.S. Meara, M.K. Tompkins, K. Morris, E. Sullivan, S.P. Ardoin, E. peters
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Systemic lupus erythematous (SLE) is a heterogeneous disease with high morbidity and mortality; requiring complex treatment plans which can be daunting especially to SLE patients with neuropsychiatric deficits. Numeracy is the "ability to use and understand numbers in daily life" and a key component for effective shared-decision making between physician and patient to ensure the best patient outcomes. Numeracy skills are needed for decisions about health care risk stratification when understanding treatments, understanding potential harm and benefits of therapy and for counting pills and taking medications as prescribed. <h3>Objectives</h3> As there is a lack of information within the lupus patient population, this proposal explores the relationship between patients' numeric ability (both actual and perceived ability) and clinical outcomes fulfilling a gap in our current knowledge of how to support physician communication with patients to ensure patient understanding. <h3>Methods</h3> Patients&gt;18 recruited from IRB approved The Ohio State University Lupus, Vasculitis, Glomerulonephritis Registry. 112 patients had finished subjective numeracy (SNS) which measures patients' perception of their math ability, objective numeracy (ONS) which measures patients' actual math ability. We conducted regression analyses with ONS, SNS, and demographics as predictors of disease activity (measured by SLEDAI). We used backwards-stepwise regression, removing nonsignificant variables one at a time from the model. <h3>Results</h3> Logistic regression analysis revealed a significant interaction between ONS and SNS in predicting whether patients had the active disease or not (interaction b(SE)=-0.70 (0.33), p=0.03; ONS b(SE)=-0.13 (0.30), p=0.68; SNS b(SE)=-0.40 (0.32), p=0.21). Patients higher in both numeric competencies were least likely to have the active disease. Specifically, among those higher in ONS (+1 SD), the predicted probability of having the active disease was 11% vs. 52% for those higher vs. lower in SNS (±1 SD), respectively. In comparison, among those lower in ONS (−1SD), the likelihood of active disease was 38% vs 25% for those higher vs. lower in SNS, respectively. Thus, among patients with greater math abilities, having greater beliefs in one's abilities appeared beneficial; however, among patients with lower math abilities, greater ability beliefs appeared harmful. <h3>Conclusions</h3> Patients with greater math ability, coupled with greater beliefs in one's numeric ability, were least likely to have the active disease. This is consistent with psychological theory about actual math ability and perceived math ability as an outcome predictor. Patients that are overconfident and more active in their health and numeric tasks may make decisions that lead them to worse outcomes. The SNS and ONS may be an efficient screening tool to identify high risk SLE patients that may require extra health care needs. <h3>Disclosure of Interest</h3> None declared