The patientsʼ perspective of important glucocorticoid effects: A nominal group study among patients with Systemic Lupus Erythematosus and Myositis

Mirza, Serene Z.; Cheah, Jonathan T. L.; Ghosh, Nilasha; Robson, Joanna C.; Hill, Catherine L.; Singh, Jasvinder; Mackie, Sarah L.; Navarro-Millán, Iris; Simon, Lee S.; Goodman, Susan M.

Abstract

Background/Objective The objective of this cohort study was to understand the positive and negative effects of glucocorticoids (GCs) in patients with systemic lupus erythematosus and myositis from the patients' perspective with the aim of developing a patient-reported outcome measure. Methods Included patients were asked to participate in 1 of 5 nominal groups where demographic information and a quality-of-life questionnaire were collected. Patients were asked 2 open-ended questions on (1) benefits and (2) harms related to GC use. We used the Nominal Group Technique, a highly structured consensus method in which responses are generated, shared, and ranked. Descriptive statistics were used to summarize the results. Nominal group sessions took place from April to May 2019. Results Of 206 patients who were approached, 21 patients participated, 17 with systemic lupus erythematosus and 4 with myositis, predominantly women with more than 10 years of steroid use. The domains ranked highest for GC benefits were disease control (55 votes), fast onset of action (30 votes), increased energy (10 votes), and pain relief (10 votes). The highest-ranked negative effects were bone loss (38 votes) and weight gain (16 votes); psychological effects and damaged internal organs each received 12 votes. Conclusions The top-ranked GC effects - both benefits and harms - among patients with systemic rheumatic disease are consistent with the top domains associated with GC use reported with other inflammatory diseases. This study informs the development of a comprehensive patient-reported outcome measure that can be used across inflammatory diseases.

• Journal Article Type: Article
• Acceptance Date: Nov 4, 2019
• Online Publication Date: Jan 24, 2020
• Publication Date: 2021-09
• Deposit Date: May 15, 2020
• Publicly Available Date: Jan 25, 2021
• Journal: Journal of Clinical Rheumatology
• Print ISSN: 1076-1608
• Electronic ISSN: 1536-7355
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 6
• Pages: 232-238
• DOI: https://doi.org/10.1097/RHU.0000000000001313
• Keywords: Rheumatology, glucocorticoids, myositis, nominal group, patient perspective, systemic lupus erythematosus
• Public URL: https://uwe-repository.worktribe.com/output/5975299
• Publisher URL: https://journals.lww.com/jclinrheum/Abstract/9000/The_Patients__Perspective_of_Important.98780.aspx