Quality of Care for the Screening, Diagnosis, and Management of Lupus Nephritis Across Multiple Healthcare Settings

Details

• Alternative Title:
  Arthritis Care Res (Hoboken)
• Personal Author:
  Aggarwal, Ishita ; Li, Jing ; Trupin, Laura ; Gaynon, Lisa ; Katz, Patricia P ; Lanata, Cristina ; Criswell, Lindsey ; Murphy, Louise B ; Dall’Era, Maria ; Yazdany, Jinoos
• Description:
  Objective:
  
  We examined quality measures for screening, diagnosis and treatment of lupus nephritis (LN) among participants of the California Lupus Epidemiology Study (CLUES) across 25 different clinical sites to identify gaps in quality of care.
  
  Methods:
  
  Data from 250 lupus participants was analyzed across three sources (medical records, physician examination, and patient interviews). Overall performance on eight quality measures was calculated separately for participants with and without LN. We used generalized estimating equations in which the outcome was performance on measures, adjusting for participant demographics, lupus disease severity and practice characteristics.
  
  Results:
  
  Of 148 patients without LN, 42% had screening labs for nephritis, 38% had lupus activity serologies and 81% had blood pressure checked every 6 months. Of 102 LN patients, 67% had a timely kidney biopsy, at least 81% had appropriate treatment and 78% achieved target blood pressure within 1 year of diagnosis. Overall performance in participants across quality measures was 54% (no LN) and 80% (LN). Significantly higher overall performance for screening measures for LN was seen at academic (63.4–73%) versus community clinics (37.9–38.4%). Similarly, among those with LN, higher performance in academic (84.1–85.2%) versus community clinics (54.8–60.2%) was observed for treatment measures.
  
  Conclusion:
  
  In this quality of care analysis across 25 diverse clinical settings, we found relatively high performance on measures for management of LN. However, future work should focus on bridging the gaps in lupus quality of care for patients without nephritis, particularly in community settings.
  
  
• Subjects:
  Adult Article Female Humans Lupus Nephritis Male Middle Aged Quality Assurance, Health Care
• Source:
  Arthritis Care Res (Hoboken). 72(7):888-896
• Pubmed ID:
  31058460
• Pubmed Central ID:
  PMC6832767
• Document Type:
  Journal Article
• Funding:
  K24 AR074534/AR/NIAMS NIH HHSUnited States/ ; U01 DP006486/DP/NCCDPHP CDC HHSUnited States/ ; P30 AR070155/AR/NIAMS NIH HHSUnited States/ ; K24-AR074534/AR/NIAMS NIH HHSUnited States/ ; U01 DP005120/DP/NCCDPHP CDC HHSUnited States/ ; U01DP005120/ACL/ACL HHSUnited States/
• Volume:
  72
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:2fac3a6d3dbe6d3d35ca98dfdaec8a17a3296fc7c74640c3082d234ab8cb0079
• Download URL:
  https://stacks.cdc.gov/view/cdc/90004/cdc_90004_DS1.pdf
• File Type:
  [PDF - 182.20 KB ]