AB1032 INVESTIGATION OF THE INFLUENCE OF SHARED DECISION-MAKING ON THE QUALITY OF LIFE OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS:THE TRUMP2-SLE STUDY
Authors: C. Hidekawa, R. Yoshimi, N. Yajima, N. Sakurai, N. Oguro, K. Shidahara, K. Hayashi, T. Ichikawa, D. Kishida, Y. Miyawaki, K. E. Sada, Y. Shimojima, Y. Ishikawa, N. Suzuki, Y. Yoshioka, T. Komiya, Y. Kunishita, D. Kishimoto, K. Takase-Minegishi, Y. Kirino, S. Ohno, N. Kurita, H. Nakajima
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Recently, shared decision-making (SDM) has become an important process in medical care, extending its significance to the management of systemic lupus erythematosus (SLE)<sup>1</sup>. However, there are still few reports on the relationship between SDM and the improvement of quality of life (QoL) in patients with SLE. <h3>Objectives:</h3> This study aimed to analyze data from a multi-institutional SLE cohort in Japan to examine the potential contribution of SDM to the improvement of QoL. <h3>Methods:</h3> The study employed a longitudinal cohort design utilizing data from the TRUMP2 -SLE (Trust Measurement for Physicians and Patients with SLE) study. All patients were over 20 years old and diagnosed with SLE according to the revised 1997 American College of Rheumatology classification criteria. Patients were divided into two groups based on the median score of the SDM-Q-9, a measure of SDM. A general linear model was used to compare the change in LupusPRO, a QoL indicator in patients with SLE, after one year. Covariates included age, sex, duration of SLE, SLE Disease Activity Index (SLEDAI), the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), therapeutic medications (dose of glucocorticoids, immunosuppressants, hydroxychloroquine), marital status, educational background, household income, age and sex of the attending rheumatologists, and baseline LupusPRO domains. Patients with missing outcome values were excluded, and missing values were imputed using multiple imputation. <h3>Results:</h3> A total of 438 patients (87.4% female, age 46.8 ± 14.1 years) were included in the analysis. The median (IQR) baseline SDM-Q-9 score was 77.8 (62.2-91.1). There were no significant differences in age or sex between the high SDM group and the low SDM group. The high SDM group showed a significantly higher rate of immunosuppressant use and older attending rheumatologists. Multiple regression analysis identified SDM as an independent factor that enhanced overall non-health-related QoL (NHRQoL; 5.91 points [95% CI 3.04-8.78], <i>p</i> &lt;0.001, Table 1), along with the domains of 'coping' (6.04 points [0.79-11.29], <i>p</i> = 0.024) and 'satisfaction with care' (14.06 points [6.93-21.19], <i>p</i> &lt;0.001). There were trends of improvement in four domains classified as health-related QoL, 'lupus medication' (5.65 points [-0.79-12.1], <i>p</i> = 0.085), 'procreation' (8.5 points [-1.30-18.3], <i>p</i> = 0.089), 'physical function' (3.48 points [-0.59-7.55], <i>p</i> = 0.093), and 'emotional function' (4.16 points [-0.38- 8.70], <i>p</i> = 0.072), although not statistically significant. <h3>Conclusion:</h3> The study suggests the potential of SDM, particularly contributing to the enhancement of NHRQoL. <h3>REFERENCES:</h3> [1] Fanouriakis A, Kostopoulou M, Alunno A, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019;78:736–45. <h3>Acknowledgements:</h3> We thank all colleagues in our laboratories and the members of the facilities participating in the TRUMP2-SLE project for patient recruitment, data collection, suggestions, and meaningful discussions. <h3>Disclosure of Interests:</h3> Chiharu Hidekawa Chiharu Hidekawa received speaker fees from Asahi KASEI Pharma Corp., Ryusuke Yoshimi Ryusuke Yoshimi RY received speaker fees from GlaxoSmithKline PLC, AstraZeneca PLC, and Sanofi S.A., Nobuyuki Yajima: None declared, Natsuki Sakurai: None declared, Nao Oguro: None declared, Kenta Shidahara: None declared, Keigo Hayashi: None declared, Takanori Ichikawa: None declared, Dai Kishida: None declared, Yoshia Miyawaki: None declared, Ken-ei Sada: None declared, Yasuhiro Shimojima: None declared, Yuichi Ishikawa: None declared, Naoki Suzuki: None declared, Yuji Yoshioka: None declared, Takaaki Komiya: None declared, Yosuke Kunishita: None declared, Daiga Kishimoto: None declared, Kaoru Takase-Minegishi: None declared, Yohei Kirino: None declared, Shigeru Ohno: None declared, Noriaki Kurita: None declared, Hideaki Nakajima: None declared.