Lupus & antiphospholipid syndrome
Economic insecurities and patient-reported outcomes in patients with systemic lupus erythematosus in the USA: a cross-sectional analysis of data from the California Lupus Epidemiology Study
Authors' conclusion
Having any economic insecurity was associated with worse outcomes for people with SLE regardless of poverty or education.
Study context
- Population
- Adults (≥18 years) with physician-confirmed systemic lupus erythematosus (SLE) recruited from rheumatology clinics, San Francisco Bay Area, CA, USA, 2015–2018228 (90%) women
- Participants
- 252 adults
- Exposure
- Any economic insecurity vs no insecurity
- Any insecurityn = 135
- Outcome
- PROs (PROMIS, Neuro-QoL Cognitive Function, PHQ-8, GAD-7) by economic insecurity
Methodological detailscohort data (California Lupus Epidemiology Study), multivariable linear regression adjusted for demographics, SLE disease characteristics and comorbidities
- Cohort data (California Lupus Epidemiology Study)
- Multivariable linear regression adjusted for demographics, SLE disease characteristics and comorbidities
Main finding
As reported in the abstract
Physical function (PROMIS), adjusted mean score
No insecurity
48.9
adjusted mean · 95% CI 47.5–50.3
Any insecurity
45.7
adjusted mean · 95% CI 44.3–47.0
P = 0.0017
Observational data: associations, not effects.
Further findings
Adjusted mean
| Outcome | Any insecurity | No insecurity | P value |
|---|---|---|---|
| Pain interference, adjusted mean score | 54.4 (95% CI 53.0–55.8) | 52.0 (95% CI 50.5–53.5) | P = 0.031 |
| Fatigue, adjusted mean score | 54.9 (95% CI 53.3–56.5) | 50.5 (95% CI 48.8–52.3) | P = 0.0005 |
| Sleep disturbance, adjusted mean score | 52.9 (95% CI 51.4–54.5) | 49.9 (95% CI 48.3–51.6) | P = 0.012 |
| Cognitive function, adjusted mean score | 45.6 (95% CI 44.1–47.0) | 49.3 (95% CI 47.7–50.9) | P = 0.0011 |
| PHQ-8, adjusted mean score | 6.1 (95% CI 5.4–6.8) | 4.4 (95% CI 3.6–5.1) | P = 0.0013 |
| GAD-7, adjusted mean score | 5.2 (95% CI 4.5–5.9) | 3.3 (95% CI 2.6–4.1) | P = 0.0008 |
Original publication
Economic insecurities and patient-reported outcomes in patients with systemic lupus erythematosus in the USA: a cross-sectional analysis of data from the California Lupus Epidemiology Study. Lancet Rheumatol. Published 20 December 2023. doi:10.
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