Tuesday, 23 Apr 2019

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The Benefits of a Lupus Clinic

A comparative cohort study assessing the quality of care in patients with systemic lupus erythematosus (SLE) suggests that a dedicated lupus clinic has better quality measure performance compared to lupus management in a general rheumatology clinic.

A study from Rush University enrolled 150 consecutive SLE patients - with 73 followed in the general rheumatology clinic and 77 followed in a dedicated lupus clinic. 

SLE patients seen in the lupus clinic had significantly better overall quality measure performance (85.8% versus 70.2%; P = 0.001).

Differences between the 2 groups showed that the lupus clinic outperformed the general rheumatology clinic in:

  • sunscreen counseling (98.7% and 83.6%; P = 0.001)
  • antiphospholipid antibody testing (71.4% and 37%; P < 0.001)
  • pneumococcal vaccination (84.8% and 48.8%; P < 0.001)
  • bone mineral density testing (94.2% and 54.5%; P < 0.001)
  • drug counseling (92.2% and 80.8%, P = 0.04)
  • steroid‐sparing (100% and 82%;P < 0.007);
  • angiotensin‐converting enzyme inhibitor use (94.4% and 58.3%; P = 0.03)
  • cardiovascular disease risk assessment (40.3% and 15.1%; P = 0.01).
  • They found a moderate correlation between physician volume and quality measure performance (ρ = 0.48, P < 0.001).

A dedicated lupus clinic appears to provide more comprehensive lupus care. These measures need to be considered by general rheumatologist for enhanced incorporation into their practices or alternatively consider the need for a focused lupus clinic in their overall care model. 

The author has no conflicts of interest to disclose related to this subject

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