Clinical
Abstract Submission
Paul Fortin, MD, MPH, FRCPC
Clinical Scientist and Rheumatologist
CHU de Québec - Université Laval
Université Laval
Carolyn Neville, RN
Research Nurse
McGill University Health Centre Research Institute
Anne-Sophie Julien, MSc
Biostatistician
Université Laval
Elham Rahme, PhD
Assciate Professor of Medicine
McGill University Health Centre Research Institute
Murray Rochon, BArc
Founder and President
Jack Digital Productions Inc.
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Vinita Haroun, MSc
Patient Advocate
Lupus Canada
Evelyne Vinet, MD, PhD, FRCPC
Assistant Professor
Department of Medicine, Division of Rheumatology, Faculty of Medicine, McGill University
Christine Peschken, MD, MSc, FRCPC
Associate Professor
Faculty of Medicine, Department of Internal Medicine, University of Manitoba
University of Manitoba
Ann Clarke, MD, MSc, FRCPC
Professor
Division of Rheumatology, Cumming School of Medicine, University of Calgary
Janet Pope, MD, MPH, FRCPC
Professor of Medicine
University of Western Ontario
Stephanie Keeling, MD, MSc, FRCPC
Associate Professor of Medicine
University of Alberta
Antonio Avina-Zubieta, MD, PhD, FRCPC
Associate Professor of Medicine
Arthritis Research Canada, Univeristy of British Columbia
University of British Columbia
Douglas Smith, MD, FRCPC
Associate Professor of Medicine
University of Ottawa
Mark Matsos, MD, FRCPC
Associate Professor of Medicine
McMaster University
Marie Hudson, MD, MPH, FRCPC
Assistant Professor of Medicine
McGill University
Jodie Young
Patient Advisor
Lupus Interactive Navigator Patient Advisory Committee
Anna-Lisa Morrison
Patient Advisor
Lupus Interactive Navigator Patient Advisory Committee
Davy Eng
Research Associate
CHU de Québec - Université Laval
Deborah DaCosta, PhD
Associate Professor of Medicine
McGill University Health Centre Research Institute
Background : Systemic Lupus Erythematosus (SLE) is an unpredictable multisystem chronic disease that leads to insecurity, requires life-style adaptations, work accommodations and longterm medication use. We previously reported that a web-based interactive navigator named MyLupusGuide (MLG) was well accepted by lupus patients and met with their informational needs. When used without reinforcement however MLG did not change patient activation towards self-management. We performed additional analyses to test if subgroups of patients were more likely to become activated than others in a large lupus population.
Methods : Population and recruitment strategy: Patients from ten lupus centers were randomized to either immediate access to MLG (NOW) or usual care (LATER). Partial cross-over occurred at three months and there was a final assessment at six months. Data collected: Demographic and socioeconomic data were collected at baseline. The 13-item Patient Activation Measure (PAM) was used to assess patient`s healthcare engagement. Higher PAM score relates to greater engagement. Additional self-reported measures for self-efficacy (Lupus Self-Efficacy Scale - LSES) and coping strategies (Coping with Health Injuries and Problems - CHIP) were obtained at baseline, 3 and 6 months. Statistical analyses: Linear mixed models were used to test the evolution of PAM over time between groups. This abstract reports on the following subanalyses: analyses of the subgroup with low PAM score at baseline and of being male or female, and analyses of other outcomes such as LSES and CHIP.
Results : A total of 541 of 1920 (28%) lupus patients responded at baseline, 399 at 3 months and 355 at 6 months. At baseline, mean (sd) age = 50.1 (14.2) years, female = 93%, Caucasian = 74%, disease duration = 16.9 (11.9) years and PAM score = 61.1 (13.5). The following subanalyses (Table 1) showed a beneficial effect of MLG on activation after three months in the subgroup of patients with low PAM at baseline, as well as for men. A significant improvement in LSES was also observed after 3 months of exposure to MLG but there was no change in CHIP.
Conclusions : At 3 months, access to MLG improved activation in patients with a low activation at baseline and in men. Self-efficacy also improved significantly without changes in coping strategies. The MLG is a unique web-based resource that provides reliable information for patients with lupus to assist them with disease management and lifestyle adaptations.