title: Participatory patient-physician communication and morbidity in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To examine associations between active patient-physician communication and measures of morbidity in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Audiotapes of routine visits between 79 women with SLE and their rheumatologists were coded for active patient participation and the degree of patient-centered communication of the physician, using a validated coding scheme. Measures of SLE activity, functional disability, and permanent organ damage were recorded at the same visit. Permanent organ damage was reassessed in 68 patients after a median of 4.7 years.
  
  
  RESULTS
  Patients who participated more actively in their visits had less permanent organ damage, as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and tended to accrue less organ damage over time. There were no associations between either active patient participation or physicians' patient-centered communication scores and measures of SLE activity or functional disability.
  
  
  CONCLUSIONS
  Patients with SLE who participated more actively in their visits had less permanent organ damage, suggesting that involving patients more in their care may decrease morbidity.
authors.affiliation: Veterans Affairs Palo Alto Health Care System and Stanford University School of Medicine, Stanford, CA, USA. wardm1@mail.nih.gov
authors.forename: Michael M
authors.initials: MM
authors.lastname: Ward
authors.forename: Saigeetha
authors.initials: S
authors.lastname: Sundaramurthy
authors.forename: Debra
authors.initials: D
authors.lastname: Lotstein
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Bush
authors.forename: C Michael
authors.initials: CM
authors.lastname: Neuwelt
authors.forename: Richard L
authors.initials: RL
authors.lastname: Street
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D003142:Communication; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D010817:Physician-Patient Relations; D012720:Severity of Illness Index; D012959:Socioeconomic Factors