Rheumatologist burnout and patient trust in systemic lupus erythematosus: a multicentre cross-sectional study from the TRUMP2-SLE project.

Abstract

To examine whether rheumatologist burnout is associated with lower patient trust in rheumatologists among patients with systemic lupus erythematosus (SLE). We conducted a multicentre cross-sectional study using baseline data from the Trust Measurement for Physicians and Patients with Systemic Lupus Erythematosus (TRUMP2-SLE) study in Japan. Burnout among rheumatologists was assessed using the Maslach Burnout Inventory-General Survey. Patient trust in attending rheumatologists was evaluated using the 5-item Abbreviated Wake Forest Physician Trust Scale (0-100 scale). Multivariable general linear models with cluster-robust standard errors clustered by rheumatologist were used to estimate adjusted mean differences in trust scores according to burnout status and burnout domain count. Missing covariate data were handled using multiple imputation by chained equations. A total of 422 patients with SLE treated by 38 rheumatologists were included. Among rheumatologists, 71.1% met predefined burnout criteria in at least one domain. Rheumatologist burnout was associated with lower patient trust scores (adjusted mean difference, -4.20; 95% confidence interval [CI], -7.88 to - 0.52; P = 0.025). Increasing burnout domain count was also associated with lower trust (per 1-domain increase, -3.76; 95% CI, -6.09 to - 1.43; P = 0.002). Compared with patients treated by rheumatologists without burnout domains, those treated by rheumatologists meeting burnout criteria in two domains had significantly lower trust scores (-7.87; 95% CI, -13.14 to - 2.59; P = 0.010). Rheumatologist burnout was significantly associated with lower patient trust in rheumatologists among patients with SLE. These findings highlight physician well-being as an important consideration in maintaining patient trust in long-term rheumatology care.