In the American Indian/Alaska Native population, specialist diagnosis of systemic lupus erythematosus (SLE) was associated with a higher likelihood of having SLE classification criteria documented, being tested for biomarkers of disease, and receiving treatment with certain disease modifying antirheumatic drugs (DMARDs). This according to a recent study of individuals (n=320) from the 2009 Indian Health Service lupus registry population with a diagnosis of SLE documented by either a primary care provider or specialist. Researchers found:
- Out of total participants, 249 had the diagnosis documented by a specialist, with 71 documented by primary care.
- Individuals with a specialist diagnosis of SLE were more likely to have medical record documentation of meeting criteria for SLE by all criteria sets (American College of Rheumatology, 79% vs 22%; Boston Weighted, 82% vs 32%; and Systemic Lupus International Collaborating Clinics, 83% vs 35% for all comparisons).
- In addition, specialist diagnosis was associated with documentation of ever having been tested for anti-double-stranded DNA antibody and complement 3 and complement 4.
- Documentation of ever receiving specific DMARD treatment was also more common with specialist diagnosis (86% vs 64%).
McDougall JA, Helmick CG, Lim SS, et al. Differences in the diagnosis and management of systemic lupus erythematosus by primary care and specialist providers in the American Indian/Alaska Native population. [Published online ahead of print March 19, 2018]. Lupus. doi:10.1177/0961203318763529.