Utilization of preventive services in a systemic lupus erythematosus population-based cohort: a Lupus Midwest Network (LUMEN) study.

Cancer screening Cardiovascular risk DXA Diabetes Influenza Osteoporosis Pneumococcal Preventive services Systemic lupus erythematosus Vaccine Zoster

Journal

Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438

Informations de publication

Date de publication:
01 09 2022
Historique:
received: 23 04 2022
accepted: 24 07 2022
entrez: 1 9 2022
pubmed: 2 9 2022
medline: 9 9 2022
Statut: epublish

Résumé

Systemic lupus erythematosus (SLE) is a disease that can lead to damage of multiple organs and, along with certain treatments, increase the risk of developing cancer, cardiovascular disease, diabetes, osteoporosis, and infections. Preventive services are particularly important in patients with SLE to mitigate the aforementioned risks. We aimed to evaluate the trends of preventive services utilization in patients with systemic lupus erythematosus, compared with non-SLE population. All ≥19-year-old patients in the Lupus Midwest Network (LUMEN) registry, a population-based cohort, with SLE on January 1, 2015, were included and matched (1:1) by sex, age, race, and county to non-SLE comparators. Among both groups, we compared the rates of screenings for breast and cervical cancer, hypertension, hyperlipidemia, diabetes mellitus, and osteoporosis as well as immunizations. We included 440 SLE patients and 430 non-SLE comparators. The probability of breast cancer screening among women with SLE was similar to comparators (hazard ratio [HR] 1.09, 95% CI 0.85-1.39), while cervical cancer screening was lower (HR 0.75, 95% CI 0.58-0.96). Hypertension screening was higher among patients with SLE (HR 1.35, 95% CI 1.13-1.62); however, hyperlipidemia screening was similar to comparators (HR 1.16, 95% CI 0.96-1.41). Diabetes and osteoporosis screenings were more likely to be performed for SLE patients than for comparators (HR 2.46, 95% CI 2.11-2.87; and HR 3.19, 95% CI 2.31-4.41; respectively). Influenza and pneumococcal immunizations were higher among SLE patients (HR 1.31, 95% CI 1.12-1.54; and HR 2.06, 95% CI 1.38-3.09; respectively), while zoster vaccination was similar (HR 1.17, 95% CI 0.81-1.69). The trends of utilization of preventive services by SLE patients vary according to screening or vaccine compared with the general population. Considering these differences, we demonstrate an opportunity for improvement, particularly in cervical cancer, hyperlipidemia, and osteoporosis screenings and vaccinations.

Sections du résumé

BACKGROUND
Systemic lupus erythematosus (SLE) is a disease that can lead to damage of multiple organs and, along with certain treatments, increase the risk of developing cancer, cardiovascular disease, diabetes, osteoporosis, and infections. Preventive services are particularly important in patients with SLE to mitigate the aforementioned risks. We aimed to evaluate the trends of preventive services utilization in patients with systemic lupus erythematosus, compared with non-SLE population.
METHODS
All ≥19-year-old patients in the Lupus Midwest Network (LUMEN) registry, a population-based cohort, with SLE on January 1, 2015, were included and matched (1:1) by sex, age, race, and county to non-SLE comparators. Among both groups, we compared the rates of screenings for breast and cervical cancer, hypertension, hyperlipidemia, diabetes mellitus, and osteoporosis as well as immunizations.
RESULTS
We included 440 SLE patients and 430 non-SLE comparators. The probability of breast cancer screening among women with SLE was similar to comparators (hazard ratio [HR] 1.09, 95% CI 0.85-1.39), while cervical cancer screening was lower (HR 0.75, 95% CI 0.58-0.96). Hypertension screening was higher among patients with SLE (HR 1.35, 95% CI 1.13-1.62); however, hyperlipidemia screening was similar to comparators (HR 1.16, 95% CI 0.96-1.41). Diabetes and osteoporosis screenings were more likely to be performed for SLE patients than for comparators (HR 2.46, 95% CI 2.11-2.87; and HR 3.19, 95% CI 2.31-4.41; respectively). Influenza and pneumococcal immunizations were higher among SLE patients (HR 1.31, 95% CI 1.12-1.54; and HR 2.06, 95% CI 1.38-3.09; respectively), while zoster vaccination was similar (HR 1.17, 95% CI 0.81-1.69).
CONCLUSIONS
The trends of utilization of preventive services by SLE patients vary according to screening or vaccine compared with the general population. Considering these differences, we demonstrate an opportunity for improvement, particularly in cervical cancer, hyperlipidemia, and osteoporosis screenings and vaccinations.

Identifiants

pubmed: 36050780
doi: 10.1186/s13075-022-02878-8
pii: 10.1186/s13075-022-02878-8
pmc: PMC9434086
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

211

Subventions

Organisme : NCCDPHP CDC HHS
ID : U01 DP006491
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002377
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG034676
Pays : United States
Organisme : CDC HHS
ID : U01 DP006491
Pays : United States

Informations de copyright

© 2022. The Author(s).

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Auteurs

Baptiste Chevet (B)

Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA.
Division of Rheumatology, Brest Teaching Hospital; LBAI, UMR1227, Univ Brest, Inserm, CHU de Brest, Brest, France.

Gabriel Figueroa-Parra (G)

Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA.

Jeffrey X Yang (JX)

Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Mehmet Hocaoglu (M)

Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA.

Shirley-Ann Osei-Onomah (SA)

Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA.

Cassondra A Hulshizer (CA)

Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.

Tina M Gunderson (TM)

Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.

Divi Cornec (D)

Division of Rheumatology, Brest Teaching Hospital; LBAI, UMR1227, Univ Brest, Inserm, CHU de Brest, Brest, France.

Kamil E Barbour (KE)

Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Kurt J Greenlund (KJ)

Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Cynthia S Crowson (CS)

Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA.
Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.

Alí Duarte-García (A)

Division of Rheumatology, Mayo Clinic, Rochester, 200 First Street SW, MN, 55905, USA. duarte.ali@mayo.edu.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. duarte.ali@mayo.edu.

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