Evidence map›Paper›PMID 35733186›Full record

ArticleArthritis research & therapy2022

Association of clinic setting with quality indicator performance in systemic lupus erythematosus: a cross-sectional study.

Sidha Sreedharan, Ning Li, Geoff Littlejohn, Russell Buchanan, Mandana Nikpour, Eric Morand, Alberta Hoi, Vera Golder

Open access · goldAbstract read
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Article in Arthritis research & therapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Sidha SreedharanMonash University, Melbourne, Australia. sidha.sreedharan@monash.edu.ORCID 0000-0002-1227-9083
Ning LiMonash University, Melbourne, Australia.
Geoff LittlejohnMonash University, Melbourne, Australia.
Russell BuchananAustin Health, Melbourne, Australia.
Mandana NikpourThe University of Melbourne at St Vincent's Hospital Melbourne, Melbourne, Australia.
Eric MorandMonash University, Melbourne, Australia.
Alberta HoiMonash University, Melbourne, Australia.
Vera GolderMonash University, Melbourne, Australia.
Monash Health · AUMonash University · AUAustin Health · AUThe University of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealthcare quality for systemic lupus erythematosus (SLE) is a modifiable target for improving patient outcomes. We aimed to assess the quality of care processes in different clinic settings, comparing a subspecialty lupus clinic with hospital-based and private general rheumatology clinics.

methodsPatients with SLE (n = 258) were recruited in 2016 from a subspecialty lupus clinic (n = 147), two hospital general rheumatology clinics (n = 56) and two private rheumatology clinics (n = 55). Data were collected from medical records and patient questionnaires. Quality of care was assessed using 31 validated SLE quality indicators (QI) encompassing diagnostic work-up, disease and comorbidity assessments, drug monitoring, preventative care and reproductive health. Per-QI performance was measured as a percentage of patients that met the QI relative to the number of patients eligible. Per-patient QI performance was calculated as a percentage of QIs met relative to the number of eligible QIs for each patient. Per-QI and per-patient QI performance were compared between the three clinic settings, and multiple regression performed to adjust for sociodemographic, disease and healthcare factors.

resultsPer-QI performance was generally high across all clinic settings for diagnostic work-up, comorbidity assessment, lupus nephritis, drug monitoring, prednisolone taper, osteoporosis and pregnancy care. Median [IQR] per-patient performance on eligible QIs was higher in the subspeciality lupus clinic (66.7% [57.1-74.1]) than the hospital general rheumatology (52.7% [47.5-58.1]) and private rheumatology (50.0% [42.9-60.9]) clinics (p <0.001) and the difference remained significant after multivariable adjustment. The subspecialty lupus clinic recorded higher per-QI performance for documentation of disease activity, disease damage, cardiovascular risk factor and drug toxicity assessments, pre-immunosuppression hepatitis and tuberculosis screening, new medication counselling, vaccinations, sun avoidance education and contraception counselling.

conclusionsSLE patients managed in a subspecialty lupus clinic recorded higher per-patient QI performance compared to hospital general rheumatology and private rheumatology clinics, in part related to better documentation on certain QIs.

Indexed as

Lupus Erythematosus, SystemicOsteoporosisRheumatologyCross-Sectional StudiesFemaleHumansPregnancyQuality Indicators, Health CareQuality indicatorsQuality of careSystemic lupus erythematosus

Identifiers

PMID35733186
PMCPMC9214991
OpenAlexW4283365883

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.