Background/Purpose: Systemic lupus erythematosus (SLE) is a chronic illness frequently complicated by infections, cardiovascular disease (CVD) and cancer. Primary care preventive services (PCS) are recommended to prevent these complications among individuals at risk. Yet, the utilization of PCS in the US may be more challenging for SLE patients, especially given the worse SLE outcomes among ethnic minorities and those with low socioeconomic status. We compared the likelihood that a cohort of SLE patients from a large metropolitan area in Atlanta, GA, US received recommended PCS relative to the baseline rates of PCS in the same community from a national population-based survey.

Methods: The Georgians Organized Against Lupus (GOAL) is a cohort of validated SLE patients predominantly derived from the Georgia Lupus Registry, a population-based registry of lupus in the Atlanta metropolitan area. GOAL includes the full sociodemographic spectrum of SLE patients and collects self-reported measures on health care utilization and health conditions. Eleven self-reported PCS were assessed in 765 SLE GOAL participants (94% women, 78% blacks,18% uninsured) and 3 representative samples of individuals (9040 from the same community, 938 of them with diabetes, and 620 with CVD) derived from the Behavioral Risk Factor Surveillance System (BRFSS). We compared the proportion of eligible SLE and BRFSS individuals who received the recommended PCS on (1) immunizations, (2) cancer screening, (3) cholesterol monitoring, (4) counseling on medications and lifestyle modifications for high blood pressure (HBP), and (5) all 11 recommended PCS.

Results:

                                                                                Eligible SLE and BRFSS participants who received recommended PCS   

Conclusion: Although only 45% of eligible SLE participants received the recommended immunizations, the proportion was higher than in the community or those with diabetes, and similar to CVD. Over 78% of SLE received complete cancer screening services, which was comparable to the other BRFSS groups. However, only 65% of SLE participants were adequately screened for cholesterol, a lower proportion than in the BRFSS samples. Counseling on hypertension was reported by less than 50% of SLE, similar to the BRFSS groups. Less than 20% of SLE responders received all recommended PCS. Further research is needed to identify factors associated with gaps in the utilization of primary care among SLE patients.