Limited Access to Systemic Lupus Erythematosus: A Systematic Review

Area of Science:

• Rheumatology
• Health Services Research
• Health Equity

Background:

• Systemic lupus erythematosus (SLE) care disparities affect patient outcomes, interventions, and specific populations.
• Inequities exist across gender, race/ethnicity, and geographic regions.
• Understanding these disparities is crucial for improving SLE management.

Purpose of the Study:

• To systematically review literature on access to care for SLE patients.
• To identify key themes related to healthcare access barriers and facilitators.
• To explore potential solutions for addressing SLE care inequities.

Main Methods:

• Systematic literature review adhering to PRISMA guidelines.
• Searched major databases including PubMed, Scopus, Web of Science, Cochrane Library, and EBSCO.
• Included studies on economic burden, access barriers/facilitators, and solutions for SLE care.

Main Results:

• Identified 77 relevant articles.
• Revealed five critical issues: economic burden, access barriers/facilitators, utilization, adherence, and solutions.
• Social factors like transportation, insurance, and mental health access are significant barriers.

Conclusions:

• Healthcare access and utilization are influenced by socioeconomic status, ethnicity, education, and residency.
• Low education, SES, rural location, and depression impact adherence.
• Solutions include peer support, digital platforms (telemedicine), and community-based programs to reduce inequities.