Race, ethnicity and education levels linked to delays accessing lupus specialty care

November 13, 2016

Lupus patients who are African-American or Asian, or those who have attained only a high school education or less, had longer delays in seeing a rheumatologist or nephrologist for a confirmed diagnosis than other groups, according to new research findings presented this week at the 2016 ACR/ARHP Annual Meeting in Washington.

Systemic lupus erythematosus (SLE) is a chronic disease that causes inflammation that affects the skin, joints, kidneys and other organs. Lupus occurs 10 times more often in women than men, and also may have a higher prevalence among some ethnic groups. It's a complex disease that requires treatment by a specialist such as a rheumatologist or nephrologist.

Researchers at the California Pacific Medical Center and UCSF in San Francisco analyzed data from the California Lupus Epidemiology Study (CLUES) to explore disparities in outcomes among from racial and ethnic minorities, as well as individuals with lower education or socioeconomic status, compared to other lupus patients. One focus of the study was time of delay to see a specialist.

"Lupus is a complex disease requiring specialized treatment, and prompt referral to a specialist is integral in ensuring patients have the best possible outcomes," said Lisa Gaynon, MD, a resident at California Pacific Medical Center in San Francisco, and a lead author of the study. "We were interested in identifying whether patients were experiencing significant delays to seeing a specialist and if so, which populations were at highest risk for delays."

The study looked at 196 lupus patients with a mean age of 45 years. Of these, 13 percent had a or less, 34 percent had limited health literacy, and 13 percent were below 125 percent of the U.S. federal poverty level. Thirty percent of the patients were Caucasian, 22 percent were Hispanic, 14 percent were African-American and 33 percent were Asian.

Overall, delays between onset of and disease diagnosis were common, with 32 percent of patients waiting over 1 year to receive a diagnosis. This finding did not differ significantly for any patient group. Of the 43 percent of patients who were initially diagnosed by a physician other than a rheumatologist or nephrologist, 24 percent experienced a delay in referral to a specialist of more than three months. In addition, while 92 percent of Caucasians and 85 percent of Hispanics saw a specialist within three months, only 64 percent of African-Americans and 66 percent of Asians did. Of those with a high school education or less, only 45 percent were referred to a specialist within three months compared to 81 percent of patients with a higher level of education.

Disparities in the time from diagnosis to access to specialty care to treat and manage patients' lupus are significant, the study's authors said. African-Americans, Asians, and those with a education or less are most at risk for these potentially detrimental delays in care.

"These results identify populations who are at a significant disadvantage when it comes to accessing specialist care for their . The next step in our research will be to look closer at which variables may be playing a role in these delays, for example, transportation, geographic distribution of specialists and health insurance, so we can start to develop targeted solutions to this problem," said Dr. Gaynon.

Explore further: Lower mortality rates among Asian and Hispanic lupus patients

Related Stories

Lower mortality rates among Asian and Hispanic lupus patients

January 15, 2015
A new study by researchers from Brigham and Women's Hospital in Boston, Massachusetts reveals that Asian and Hispanic patients with systemic lupus erythematosus (SLE) have lower mortality rates compared to Black, White, or ...

Communication and coordination of care are important for ensuring lupus patients' health

September 7, 2016
Results from a recent study suggest that improved communication and coordination of care between patients, physicians, and health insurers can provide important health benefits for patients with lupus.

Lupus may contribute to pregnancy-related complications

February 1, 2016
A new study found that lupus during pregnancy may have negative health impacts for women and their babies. The study included 13,598 Swedish women in their first pregnancy, and all were singleton pregnancies. Preeclampsia, ...

Pediatric discoid lupus carries significant progression risk

April 3, 2015
(HealthDay)—Pediatric discoid lupus erythematosus (DLE) carries a significant risk of progression to systemic lupus erythematosus (SLE), according to a review published in the April issue of the Journal of the American ...

Monash researchers bringing hope to lupus patients

May 10, 2016
Researchers at Monash University are leading the world's largest study to describe lupus patients and disease characteristics, bringing treat-to-target options for lupus a step closer.

Recommended for you

Fluid in the knee holds clues for why osteoarthritis is more common in females

June 26, 2017
Researchers have more evidence that males and females are different, this time in the fluid that helps protect the cartilage in their knee joints.

Biologics before triple therapy not cost effective for rheumatoid arthritis

May 29, 2017
Stepping up to biologic therapy when methotrexate monotherapy fails offers minimal incremental benefit over using a combination of drugs known as triple therapy, yet incurs large costs for treating rheumatoid arthritis (RA). ...

Drug for refractory psoriatic arthritis shows promise in clinical trial

May 24, 2017
In a pivotal phase-3 clinical trial led by a Stanford University School of Medicine investigator, patients with psoriatic arthritis for whom standard-of-care pharmaceutical treatments have provided no lasting relief experienced ...

Cross-species links identified for osteoarthritis

May 17, 2017
New research from the University of Liverpool, published today in the journal npj Systems Biology and Applications, has identified 'cell messages' that could help identify the early stages of osteoarthritis (OA).

Osteoarthritis could be prevented with good diet and exercise

May 12, 2017
Osteoarthritis can potentially be prevented with a good diet and regular exercise, a new expert review published in the Nature Reviews Rheumatology reports.

Rodents with trouble walking reveal potential treatment approach for most common joint disease

May 11, 2017
Maintaining the supply of a molecule that helps to nourish cartilage prevented osteoarthritis in animal models of the disease, according to a report published in Nature Communications online May 11.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.