Blockades in the Pathway of Specialty Care in Systemic Lupus Erythematosus: A Report Based on Indian Rheumatology Association Database

    November 2024 in “ Indian Journal of Rheumatology ”
    Alakendu Ghosh, S Chandrashekara, Padmanabha Shenoy, Uma Kumar, Sapan C Pandya, Apurva Khare, Rajkiran Dudam, Rudra Prosad Goswami
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    Studysummary This study reported that primary care physicians' lack of knowledge about rheumatology and referrals to other specialties are major factors delaying systemic lupus erythematosus patients' access to rheumatology care in India. Our plain-language summary of this paper — not a Tressless recommendation.
    The study, using data from 786 patients, identifies significant delays in referring systemic lupus erythematosus (SLE) patients to rheumatology specialists in India, with a median delay of 1 month. Major causes include management by non-rheumatologists (93%) and lack of awareness of rheumatology care (89%). Over 25% of primary care physicians were unaware of rheumatology as a specialty, and nearly 30% of patients were misdiagnosed. Early referral within 6 months is associated with fewer systemic complications, with joint pain, hair loss, and weight loss being predictors for early referral. The study suggests educating primary care physicians and facilitating direct referrals to reduce delays.
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