A study of racial/ethnic differences in treatment preferences among lupus patients.
Rheumatology (Oxford)
; 51(9): 1697-706, 2012 Sep.
Article
em En
| MEDLINE
| ID: mdl-22653381
ABSTRACT
OBJECTIVES:
To determine whether there are racial/ethnic differences in the willingness of SLE patients to receive CYC or participate in clinical trials, and whether demographic, psychosocial and clinical characteristics contribute to these differences.METHODS:
Data from 120 African-American and 62 white lupus patients were evaluated. Structured telephone interviews were conducted to determine treatment preferences, as well as to study characteristics and beliefs that may affect these preferences. Data were analysed using serial hierarchical multivariate logistic regression and deviances were calculated from a saturated model.RESULTS:
Compared with their white counterparts, African-American SLE patients expressed less willingness to receive CYC (67.0% vs 84.9%, P = 0.02) if their lupus worsened. This racial/ethnic difference remained significant after adjusting for socioeconomic and psychosocial variables. Logistic regression analysis showed that African-American race [odds ratio (OR) 0.29, 95% CI 0.10, 0.80], physician trust (OR 1.05, 95% CI 1.00, 1.12) and perception of treatment effectiveness (OR 1.40, 95% CI 1.22, 1.61) were the most significant determinants of willingness to receive CYC. A trend in difference by race/ethnicity was also observed in willingness to participate in a clinical trial, but this difference was not significant.CONCLUSION:
This study demonstrated reduced likelihood of accepting CYC in African-American lupus patients compared with white lupus patients. This racial/ethnic variation was associated with belief in medication effectiveness and trust in the medical provider, suggesting that education about therapy and improved trust can influence decision-making among SLE patients.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Planejamento de Assistência ao Paciente
/
Antirreumáticos
/
Ciclofosfamida
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Tomada de Decisões
/
Preferência do Paciente
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Lúpus Eritematoso Sistêmico
/
Grupos Minoritários
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Rheumatology (Oxford)
Ano de publicação:
2012
Tipo de documento:
Article