Patient discussions
As with any other chronic disease, establishing a partnership with the patient to improve their health is an important part of the management plan. Patient education is fundamental and directing patients to useful resources should be encouraged. The Lupus Foundation website is a useful resource. Lupus Foundation of America Opens in new window
Patients with SLE should be advised to avoid excessive sun exposure and to use a sunblock with a sun protection factor (SPF) of ≥15. They should also be aware that certain drugs can exacerbate the disorder.
In women of reproductive age, conception and pregnancy-related issues should be discussed early in the disease course so that specialist advice can be given and patients counselled regarding outcomes in relation to disease-related activity. Studies suggest that patients with SLE with stable disease can safely use oral contraceptives.[173][174] Patients with active disease and patients at risk for thrombosis should avoid the use of oral contraceptives.
Although >50% of all lupus pregnancies are completely normal, all pregnant lupus patients would be considered high risk and be managed by a specialist obstetric team. Pregnant lupus patients should continue on hydroxychloroquine throughout pregnancy.[175]
Patients who smoke should be encouraged to adopt strategies to stop as SLE is associated with higher than expected late cardiovascular risk as well as worsening Raynaud's symptoms and lupus-related skin disease.
Symptoms of concern should be outlined and are discussed in the Lupus Foundation website. Lupus Foundation of America Opens in new window
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