Background/Purpose:  Pediatric systemic lupus erythematosus (SLE) accounts for approximately 10-20% of all cases of SLE. It is more common in African American and Hispanic patients, who together comprise the majority of our Bronx population. It can be a challenging diagnosis for providers to make but early recognition is especially important, as pediatric patients typically have more severe disease than adults. The objectives of this project are for pediatric primary care and emergency room providers to be able to recognize the symptoms and signs of lupus, to initiate a work-up, and to identify high-risk patients who would benefit from prompt referral to pediatric rheumatology.

Methods:  First, a comprehensive, interactive presentation on pediatric lupus and a relevant knowledge assessment tool, consisting of 9 multiple-choice questions, were developed. These new materials were tested on a small group of providers affiliated with a nearby, community hospital. Then, formal seminars were scheduled with groups of providers affiliated with The Children’s Hospital at Montefiore during regular, weekly meeting times. These included pediatric primary care, adolescent medicine, and pediatric emergency medicine providers. At the seminars, participants were asked to complete voluntary, de-identified pre and post assessments, and were informed about completing an online version in 4-6 weeks (follow-up assessment). Paired t-tests were used to calculate the changes in knowledge for matched data. Participants were also asked to comment on their intent to make practice changes.

Results:  Eighty-one providers attended the 8 seminars, and 57 matched pre and post assessments were collected. Of participants who completed the post-assessment, 94.9% agreed that the seminar improved their medical or practice knowledge. Of those with matched responses, 96.4% demonstrated an increase in knowledge on the assessment tool, with a score difference of 3.02 on a 9-point scale (p <.001). In addition, of participants who completed the post-assessment, 90.4% indicated that they will make changes that will benefit patient care as a direct result of the seminar. The mean follow-up assessment scores remained higher than the pre-assessment scores for 7 out of 9 questions. Lastly, of those who completed the follow-up assessment, 40% indicated that they are more likely to think of lupus in the differential diagnosis.

Conclusion:  After a brief educational intervention, pediatric primary care and emergency room providers demonstrate knowledge gains, some of which are sustained. Importantly, they are also more likely to consider lupus in this high-risk population.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-pediatric-rheumatology-fellow-educating-pediatric-primary-care-and-emergency-room-providers-about-pediatric-lupus-a-local-pilot-adaptation-of-the-lupus-education-advancement-project-leap/