POS0172 DISEASE COPING MECHANISMS AND QUALITY OF LIFE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

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Background: Systemic lupus erythematosus (SLE) is characterized by its heterogeneous clinical manifestations and chronic nature, leading to substantial physical and psychological burdens on patients. The importance of coping mechanisms in managing chronic illnesses like SLE is well-documented, as they can significantly influence both disease outcomes and patients' perceived quality of life (QoL). Objectives: This study investigates different coping strategies and their relationship with QoL in Swiss SLE patients. Methods: In this cross-sectional study, patients living in Switzerland were invited to participate in an online survey via 3 different channels: i) digital advertisements targeted to SLE patients (google search and ads), ii) newsletter of a lupus patient association (Lupus Suisse), and iii) letters to patients of a national Lupus registry (Swiss SLE Cohort Study). Patients with self-reported physician's diagnosis of SLE, aged ≥ 18 years, willing to provide electronic consent for the study, residing in Switzerland and able to read and complete the survey in German, French or Italian were included in the study. SLE coping mechanisms were evaluated using the Brief COPE inventory capturing 14 coping strategies employed by individuals facing stressful situations, ranging from 0 (I have not been doing this at all) to 3 (I have been doing this a lot). Strategies aim to changing the stressful situation such as active coping, use of informational support, planning, and positive reframing, were combined into the Problem-Focused domain. Strategies aiming at regulating emotions associated with the stressful situation such as venting, use of emotional support, humor, acceptance, self-blame, and religion, were combined into the Emotion-Focused Coping Domain. Strategies indicating physical or cognitive efforts to disengage from the stressor such as self-distraction, denial, substance use, and behavioral disengagement, were combined into the Avoidant Coping domain. Disease specific QoL was assessed using the LupusPRO TM instrument (©, 2007, Rush University Medical Center and the Board of Trustees at the University of Illinois, Chicago). Median and IQR were calculated for descriptive statistics, mean values for score calculation. To build high and low coping and QoL strata, the respective median was applied. Multiple linear regression was used to explore associations between coping mechanisms and QoL. Comparisons between independent groups were made using the Mann-Whitney U test for continuous and the Fisher's exact test for categorical data, without correction for multiplicity due to the exploratory nature of the survey. The study was approved by the Geneva Cantonal EC (2023-01927). Results: Between February 14 th and June 25 th , 2024, 282 patients were screened, of which 27 did not meet the inclusion criteria. Out of the remaining 255 patients, 109 participants left the online survey incomplete, leaving a total of 146 patients included in the analysis. Participants had a median age of 48.5 years, were predominantly female (n=125, 85.6%) and Caucasians (n=112, 76.7%). Median duration of SLE was 12 years. Problem-focused coping was the predominant domain in 108 (74.0%) patients, followed by emotion-focused coping in 25 (17.0%), and avoidant coping in 13 (9.0%) patients. Highest mean scores for individual coping mechanisms were observed for acceptance (mean score: 2.13), followed by active coping (mean score: 1.76), and planning (mean score: 1.70). Notably, substance use was reported as the least utilized coping strategy (mean score: 0.20). Regression analysis indicated a significant negative correlation between avoidant coping and QoL (β = 0.420, p < 0.05, adjusted for patient demographics, medication, disease duration, and disease activity). Figure 1 demonstrates coping scores for the total sample and the patients with low and high QoL scores. depicts patient and treatment characteristics for the total sample as well as patients with low and high avoidant coping. Significant differences were observed in the use of glucocorticoids and painkillers: Among patients using glucocorticoids (n=50), those with high avoidant coping were more likely to use a dosage of more than 5mg/day compared to those with low avoidant coping (64.5% vs. 26.3%, p < 0.05). Additionally, among patients taking other medications besides SLE treatments (n=108), those with high avoidant coping were more likely to use painkillers compared to those with low avoidant coping (45.2% vs. 23.9%, p < 0.01). Conclusion: SLE patients predominantly apply active coping strategies which aim at changing the stressful situation related to SLE. Avoidant coping and hence strategies to disengage from the stressor/ SLE, were negatively correlated to health related QoL and associated with higher use of pain medication and glucocorticoids use. These findings underscore the importance of tailored interventions to promote adaptive coping strategies, particularly focusing on problem-solving and acceptance rather than avoidance, to enhance the overall well-being of SLE patients. Additionally, SLE patients could benefit from information, application, and support programs to facilitate positive disease coping strategies. Further longitudinal investigations are required to gain more understanding of the causal relationship between coping mechanisms and QoL in SLE patients. Table 1. Treatment characteristics for the total sample and stratified based on low or high avoidant coping scores. Figure 1 REFERENCES: NIL . Acknowledgements: NIL . Disclosure of Interests: Shekoofeh Yaghmaei AstraZeneca, Jasmin Annabelle Schäfer: None declared, Kristin Schmiedeberg: None declared, Marten Trendelenburg Research collaborations with Roche, Novartis and Idorsia (all Switzerland), Johannes von Kempis: None declared, Chiara Balbo Pogliano AstraZeneca, Peter Langer AstraZeneca, Philipp Wörner AstraZeneca ETF, AstraZeneca, Carlo Chizzolini AstraZeneca, Boehringer Ingelheim (less than 10,000 Euro). © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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