The Care-coordination Approach to Learning Lupus Self-Management: a patient navigator intervention for systemic lupus inpatients

Ashley A White, Aissatou Ba, Trevor Daniel Faith, Viswanathan Ramakrishnan, Clara L Dismuke-Greer, Jim C Oates, Edith Marie Williams, Ashley A White, Aissatou Ba, Trevor Daniel Faith, Viswanathan Ramakrishnan, Clara L Dismuke-Greer, Jim C Oates, Edith Marie Williams

Abstract

Objective: The Care-coordination Approach to Learning Lupus Self-Management (CALLS) study was designed to improve SLE disease self-management. This study aims to assess the benefits of the intervention compared with existing lupus care.

Methods: Participants were randomly assigned to participate in 12-weekly phone sessions with the patient navigator that included structured educational content, care coordination and patient-centred support services, or a usual care control condition. Validated measures of health literacy, self-efficacy, patient activation and disease activity were collected. We used least squares means and linear mixed-effects regression models for each outcome variable to assess the changes in outcome, from baseline to postintervention and to estimate the difference in these changes between the intervention and control group.

Results: Thirty participants were enrolled and 14 were randomised to the treatment group. For perceived lupus self-efficacy, there was a significant increase in mean score for the intervention group, but not for the control group. With regard to disease activity, the experimental group experienced a slight decrease in mean flare score in the previous 3 months, whereas the control group experienced a slight increase, but this finding did not reach statistical significance. Trends were similar in self-reported global disease activity, but none of the findings were significant. Health literacy and patient activation measure scores remained largely unchanged throughout the study for the two groups.

Conclusion: These findings suggest that the CALLS intervention may work to improve aspects of SLE disease self-management. Future research will be needed to validate these findings long-term.

Trial registration number: NCT04400240.

Keywords: health services research; rehabilitation; systemic lupus erythematosus.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flow diagram for Care-coordination Approach to Learning Lupus Self-Management recruitment. SAE/AE, serious adverse event/adverse event.
Figure 2
Figure 2
Mean score change of health literacy over time.
Figure 3
Figure 3
Mean score change of self-efficacy over time.
Figure 4
Figure 4
Mean score change of patient activation over time.
Figure 5
Figure 5
Mean score change of disease exacerbations (flares) over time.
Figure 6
Figure 6
Mean score change of disease activity over time.

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