Hand function and performance of daily activities in systemic lupus erythematosus: a clinical study.

This clinical study was performed to investigate hand problems in individuals with systemic lupus erythematosus (SLE) in comparison with healthy controls, and to explore problems in the performance of daily activities related to these hand problems, in order to objectify findings from a previous mail survey. We also investigated whether a simple hand test could detect hand problems in SLE. All individuals, 71 with SLE and 71 healthy controls, were examined for manifestations in body structures and body functions of the hands with a study-specific protocol. The simple hand test was performed by all the individuals and the arthritis impact measurement scale (AIMS 2) questionnaire was completed by the SLE individuals. In the SLE group, 58% had some kind of difficulty in the simple hand test, compared with 8% in the control group. Fifty percent of the SLE individuals experienced problems in performing daily activities due to hand deficits. Pain in the hands, reduced strength and dexterity, Raynaud's phenomenon and trigger finger were the most prominent body functions affecting the performance of daily activities. Deficits in hand function are common in SLE and affect the performance of daily activities. The simple hand test may be a useful tool in detecting hand problems.

Adherence with advice and prescriptions in SLE is mostly good, but better follow up is needed: a study with a questionnaire.

The objective was to evaluate the efficacy of the information policy given to all systemic lupus erythematosus (SLE) patients. One hundred consecutive SLE patients were asked to answer anonymously a questionnaire covering demographic issues including education, adherence with prescriptions and advice given and methods of sourcing information. Seventy-three females and ten males responded. The demographic data showed that 34 had a university education, 29 high school and 19 primary school education. An inability to work due to disease was increased compared with the matched population (P < 0.001). Forty-two reported that they had received advice about physical training and forty of them followed this advice. Only 28 out of 46 smokers reported that they had got any advice about smoking, and out of these only 13 followed the advice. The patients with university background were less likely to smoke (P < 0.05) and followed the advice more often (P < 0.05). Most patients followed given advice about exposure to sunlight. Thirty-five percent of those prescribed glucocorticoids reported that they varied from the prescribed dosages without consultation with their specialist. This behaviour was more common in the university group (P < 0.05), this grouping also had a higher median dosage. Seventy-three patients had read the booklet about SLE provided by the clinic. Accessing internet information was more common for those with university education (P < 0.01). This study shows that on the whole SLE patients follow given advice, but adherence varies. Aside from the issue of glucocorticoid dosage adherence, educational level seems to be the most important predictor for adherence to advice. Thus, we conclude that a more individualized approach to delivery of information is required and better follow up is needed.