A task force has outlined five equitable quality measures to improve lupus clinical care as part of the new Healthy People With Lupus 2030 project, according to a press release from the American College of Rheumatology (ACR). In a report presented by Yazdany et al at ACR Convergence 2023, two interdisciplinary teams of investigators used literature reviews, modified Delphi techniques, and patient input to assess and develop novel strategies for improving quality and safety of care, outcomes, and health-care disparities for patients with lupus by 2030. The first team focused on electronic health record–based measures related to hydroxychloroquine, steroids, and renal screenings; the second team focused on patient-reported outcome measures. The quality measure recommendations included: increasing the use of hydroxychloroquine, reducing glucocorticoid use to no greater than 7.5 mg per day for a maximum of 6 months, monitoring patients for lupus nephritis biannually, decreasing the prevalence of disability among patients with lupus, and lowering rates of depression and suicide in this patient population. The investigators stressed that the steroid threshold should be further lowered in future revisions to the quality measures, and that mental health providers and resources should be more accessible to patients—especially those residing in rural areas. “We aimed for simplicity and high impact in these measures, envisioning their uniform implementation across the country. Our hope is that implementation of these measures by 2030 will lead to reduced lupus- and steroid-related morbidity, improved functional outcomes, and reduced depression and suicide among [patients] with lupus,” concluded lead study author Jinoos Yazdany, MD, MPH, Chief of Rheumatology at San Francisco General Hospital.
November 30, 2023