Background/Purpose: Systemic Lupus Erythematosus (SLE) is a complex, multifactorial disease with heterogeneous presentation. Disease activity – the number and severity of symptoms – can be influenced by a multitude of patient level and environmental factors. This examination seeks to explore the relationship between economic barriers to care and self-reported disease activity among a cohort of patients diagnosed with the disease.

Methods: Data for this study were aggregated from the baseline (pre-intervention) visits of the Peer Approaches to Lupus Self-Management (PALS) and Care Coordination Approaches to Learning Lupus Self-Management (CALLS) studies. Disease activity was assessed using the Systemic Lupus Activity Questionnaire. We used a Pearson Correlation to evaluate the correlation between disease activity and economic hardship in this using the “Systemic Lupus Activity Questionnaire” as an indicator of disease activity and questions from financial/travel surveys as indicators of economic hardship. The PALS study enrolled African American women with SLE at the Medical University of South Carolina while the CALLS study enrolled recently hospitalized SLE patients at the same institution. The CALLS study was not limited to African American women; however, the cohort was disproportionately made up of this population.

Results: There was no correlation between the indicator of disease activity during the past four weeks from and the indicators of economic barriers and financial barriers to care outside the MUSC hospital setting. As well as no correlation between disease activity and healthcare utilization outside of MUSC. There was no correlation between our indicator of disease activity during the past three months from the Systemic Lupus Activity Questionnaire and our indicators of economic barriers and financial barriers to care outside the MUSC hospital setting. As well as no correlation between our indicator of disease activity during activity during the past three months and health utilization outside of MUSC.

Conclusion: These results indicate that economic and financial barriers to care and healthcare utilization outside the MUSC hospital setting are not statistically significant to estimate short term disease activity among this cohort of lupus patients. However, the majority of Lupus Quality of Life scores were high, indicating less interference of health and emotional issues on work and daily routine. These findings suggest that long-term studies are needed to further elucidate the impact of economic barriers on disease activity among lupus patients. Impaired access to care has profound implications for chronic and progressive disease care. With limited access to appropriate primary and specialty care, SLE patients are likely to seek care in emergency departments which increases the cost of care and diverts resources from acute care needs. Moreover, patients who forgo standard care are more likely to experience disease flares and develop organ damage which can be life threatening. 

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/correlation-between-disease-activity-and-perceived-economic-barriers-to-care-in-a-population-of-african-american-women-with-systemic-lupus-erythematosus/