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

The study analyzed factors causing delays in referring systemic lupus erythematosus (SLE) patients to rheumatology specialists in India, using data from 786 patients. The median referral delay was 1 month, with a range of 1 to 192 months. Major causes included management by non-rheumatologists (93%) and lack of awareness of rheumatology (89%). Over 25% of primary care practitioners were unaware of rheumatology as a specialty, leading to incorrect diagnoses. Early referral within 6 months reduced systemic complications. Predictors for early referral included joint pain, hair loss, and weight loss, while symptoms like lung involvement and Raynaud’s phenomenon led to referrals to other specialties. The study concludes that educating primary care physicians and facilitating direct referrals to rheumatologists could reduce these delays.