title: Primary preventive services in patients with systemic lupus erythematosus: study from a population-based sample in Southeast U.S.
abstract: OBJECTIVE
  Systemic lupus erythematosus (SLE) patients are at risk for complications that can be mitigated by appropriate preventive care. We examined the receipt of immunizations, cancer screening, and cardiovascular risk preventive services in a predominantly Black cohort of SLE patients from the Southeast U.S. To identify gaps in primary preventive services (PPS) that might be specific to SLE as opposed to local health system factors, we used as reference a population-based sample from the same area.
  
  
  METHODS
  A cross-sectional design was used to characterize the percentage of PPS received by 751 SLE patients from Atlanta, GA, and 9040 subjects from the same community, of whom 938 had diabetes. Factors associated with the receipt of PPS were examined with multivariable analysis of variance.
  
  
  RESULTS
  Approximately 65% of recommended PPS were provided to the SLE, overall community (OC), and diabetes samples. However, only 22.5%, 45.7%, and 27.6% of SLE, OC, and diabetes subjects, respectively, received all recommended services. Factors associated with a higher percentage of PPS received by SLE patients included older age (63.6% if age ≥65 years, 45.8% if age between 18 and 35 years), having medical insurance (61.1% for insured, 49.7% for uninsured), having a primary care physician (PCP) (59.0% if patient had PCP, 51.8% if patient did not have PCP), and being a non-smoker (61.9% for non-smokers, 49.9% for smokers).
  
  
  CONCLUSIONS
  Less than one-quarter of SLE patients from a southeast U.S. community received all the recommended services that were studied. Further research is warranted to unravel the barriers that prevent SLE patients from reaching appropriate standards of preventive care.
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: cdrenka@emory.edu.
authors.forename: Cristina
authors.initials: C
authors.lastname: Drenkard
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Rask
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Easley
authors.forename: Gaobin
authors.initials: G
authors.lastname: Bao
authors.forename: S Sam
authors.initials: SS
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D012307:Risk Factors; D015144:Southeastern United States
keywords: Comorbidities; Preventive care; Primary preventive services; Systemic lupus erythematosus