Practice patterns in longitudinal lupus care provision: patient and physician perspectives

Area of Science:

• Rheumatology
• Clinical Practice Patterns
• Quality Improvement

Background:

• Understanding physician practice patterns is crucial for quality improvement initiatives in systemic lupus erythematosus (SLE) care.
• Physician and patient perspectives on SLE management and monitoring may differ.
• Current diagnostic and monitoring protocols for SLE require evaluation.

Purpose of the Study:

• To determine the medical care patterns provided to patients with systemic lupus erythematosus (SLE).
• To compare patient-reported experiences with physician-reported practices in SLE care.
• To identify areas for quality improvement in SLE management.

Main Methods:

• Online surveys were administered to 283 SLE patients and 86 physicians managing SLE.
• Surveys assessed longitudinal care, including visit frequency and laboratory test utilization.
• Data were analyzed using chi-square and t-tests, with a significance level of P < 0.05.

Main Results:

• Patients reported frequent antibody testing (ANA, anti-ENA, SSA/SSB) at follow-up visits.
• Physicians reported less frequent performance of these same tests during patient visits.
• Over 75% of private practice physicians ordered sedimentation rate at each visit for SLE patients.

Conclusions:

• Discrepancies between patient and physician reports suggest potential overuse of laboratory investigations in SLE care.
• There is a need for physician education regarding the appropriate indications and utility of specific laboratory tests, such as antinuclear antibody (ANA).
• Optimizing laboratory test ordering can improve the efficiency and quality of SLE patient management.