Black, Asian Lupus Patients Referred to Specialists Less Often


In a study announced at the 2016 American College of Rheumatology Annual Meeting in Washington, DC, lupus patients with less education were also likely to wait longer for referral to a specialist.

A complex disease with varied manifestations, lupus typically requires specialized, individualized treatment. A study announced at the 2016 American College of Rheumatology Annual Meeting in Washington, DC, however, found that such specialized care is not distributed equally to all lupus patients.

Researchers from the California Pacific Medical Center and from the University of California San Francisco reached this conclusion after an examination of data from the California Lupus Epidemiology Study (CLUES). In a selection of just under 200 patients, they explored race, education, and socioeconomic status in diagnosis and care of the disease.

The group was mixed: 33% Asian, 30% Caucasian, 22% Hispanic, and 14% African-American. In terms of education, 13% had high school or less, and 34% were determined to have “limited health literacy.”

Among this set, about a third of patients went a year between onset of symptoms and actual lupus diagnosis, which was consistent across the demographic groups. What was inconsistent, however, was what came after diagnosis.

While 92% of white patients and 85% of Hispanic patients were referred to a specialist within three months of diagnosis, only 66% of Asians and 64% black patients did. Additionally, only 45% of those with a high school education or less were referred in that time.

It is important to note that the study’s 196 patients are split into demographic groups, creating increasingly smaller samples. Still, Lisa Gaynon, MD, of the California Pacific Medical Center, believes this work is important in an effort to “identify populations who are at a significant disadvantage when it comes to accessing specialist care for their lupus,” citing the need to go further in determining what factors, like the geographic distribution of rheumatology specialists or the insurance status of patients, may play a role.

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