Older, lower income patients least likely to see a specialist for lupus

Despite advances in treatment, systemic lupus erythematosus (SLE) remains a serious disease. Previous studies have shown that racial and ethnic minorities and individuals with low socioeconomic status may have poorer outcomes in the long run. Other research has shown that care provided by specialists to patients with rheumatic diseases is associated with improved outcomes yet does not cost more. A new study published in the May 2007 issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) found older patients and those with lower incomes were less likely to see a specialist for SLE.

Between 2002 and 2004, researchers led by Jinoos Yazdany, MD, MPH, of the University of California, San Francisco, CA, conducted extensive telephone interviews with 982 SLE patients that included questions about visits to a rheumatologist within the past year, race/ethnicity, income, age, sex, disease severity, and type of insurance. Almost half of the participants reported a disease flare in the previous 3 months, and 22 percent reported no visits to a rheumatologist, although most of these had been seen by another type of physician.

The results showed that patients 50 or older and those with lower incomes reported far fewer visits to a rheumatologist, and that male patients were less likely to see this type of specialist than female patients. Patients falling into these groups were also less likely to identify any kind of specialist as their primary SLE physician.

The authors suggest that elderly individuals or those with lower incomes face barriers to accessing care that may include a lack of rheumatology services close by, a lack of awareness of this type of specialty, less frequent referrals to rheumatologists, or inadequate follow-up. "Subjects who were older than 50 years or in the lowest income category were twice as likely to report no rheum

Contact: Amy Molnar
John Wiley & Sons, Inc.

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