Table 10

Five studies of self-management in African-Americans with lupus

Author, yearNObjectiveResultsConclusionsLevel of evidence
Drenkard et al, 20128749To pilot test the benefits of the CDSMP in low-income African-American patients with SLEAuthors witnessed significant improvements post intervention in the short-form 36 physical health component summary (p=0.032); self-efficacy (p=0.035); and several self-management behaviours: cognitive symptoms management (p=0.036); communication with physicians (p=0.01); and treatment adherence (p=0.01).The CDSMP is a promising intervention for low-income African-Americans with SLEII
Williams et al, 20148330To examine the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in a high-risk groupAfrican-American patients with SLE experienced significant improvements in depression, social/role activities limitations, health distress, fatigue, pain and lupus self-efficacy.This intervention has the potential to reduce health problems and costs in a debilitating, management-intensive chronic disease in the population subset at highest risk for the disease and should be more widely implemented and studied to more rigorously assess benefitsII
Williams et al, 20148430To link available disease information to endpoints examined in the cohort of 30 African-American lupus patients who participated in the BLESS studyAuthors observed better outcomes in the intervention group following CDSMP workshops compared with the control group in the following areas: self-reported lupus flares, overall disease activity during the past 3 months, muscle pain and pain or stiffness in joints.
Levels of reported stress had strong effects upon functionality, especially between health distress and functionality.
If widely implemented, morbidities and mortality related to lupus could be drastically reduced in African-AmericansIII
Williams et al, 20148530To investigate relationships between stress, depression and various health behaviours in the cohort of 30 African-American lupus patients who participated in the BLESS studyDepressive symptoms had moderate effects upon social/role limitations and nights spent in the hospital.Findings could have implications for developing interventions to improve disease experience and quality of life in African-American patients with SLE struggling with stress and/or depressionIII
Williams et al, 201486330To characterise those who fully participated in the BLESS study and those who were non-compliant or non-responsive to recruitment attemptsRespondents and non-respondents to the BLESS study were similar with regard to demographic factors and disease indices, but study participants more quickly arrived at disease manifestations of renal disorder, haem disorder, and SLE diagnosis compared with non-respondents.This information can be used to develop and refine future intervention activitiesIII
  • BLESS, Balancing Lupus Experiences with Stress Strategies; CDSMP, Chronic Disease Self-Management Program; SLE, systemic lupus erythematosus.