BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018: baseline multi-centre audit in the UK

Research output: Contribution to journalArticlepeer-review

Standard

BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018 : baseline multi-centre audit in the UK. / Pearce, Fiona A; Rutter, Megan; Sandhu, Ravinder; Batten, Rebecca L; Garner, Rozeena; Little, Jayne; Narayan, Nehal; Sharp, Charlotte A; Bruce, Ian N; Erb, Nicola; Griffiths, Bridget; Guest, Hannah; Macphie, Elizabeth; Packham, Jon; Hiley, Chris; Obrenovic, Karen; Rivett, Ali; Gordon, Caroline; Lanyon, Peter C.

In: Rheumatology, 08.12.2020.

Research output: Contribution to journalArticlepeer-review

Harvard

Pearce, FA, Rutter, M, Sandhu, R, Batten, RL, Garner, R, Little, J, Narayan, N, Sharp, CA, Bruce, IN, Erb, N, Griffiths, B, Guest, H, Macphie, E, Packham, J, Hiley, C, Obrenovic, K, Rivett, A, Gordon, C & Lanyon, PC 2020, 'BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018: baseline multi-centre audit in the UK', Rheumatology. https://doi.org/10.1093/rheumatology/keaa759

APA

Pearce, F. A., Rutter, M., Sandhu, R., Batten, R. L., Garner, R., Little, J., Narayan, N., Sharp, C. A., Bruce, I. N., Erb, N., Griffiths, B., Guest, H., Macphie, E., Packham, J., Hiley, C., Obrenovic, K., Rivett, A., Gordon, C., & Lanyon, P. C. (2020). BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018: baseline multi-centre audit in the UK. Rheumatology. https://doi.org/10.1093/rheumatology/keaa759

Vancouver

Author

Pearce, Fiona A ; Rutter, Megan ; Sandhu, Ravinder ; Batten, Rebecca L ; Garner, Rozeena ; Little, Jayne ; Narayan, Nehal ; Sharp, Charlotte A ; Bruce, Ian N ; Erb, Nicola ; Griffiths, Bridget ; Guest, Hannah ; Macphie, Elizabeth ; Packham, Jon ; Hiley, Chris ; Obrenovic, Karen ; Rivett, Ali ; Gordon, Caroline ; Lanyon, Peter C. / BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018 : baseline multi-centre audit in the UK. In: Rheumatology. 2020.

Bibtex

@article{4aee1dc6081549028ad0092fb5397d97,
title = "BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018: baseline multi-centre audit in the UK",
abstract = "Objectives: To assess the baseline care provided to patients with SLE attending UK Rheumatology units, audited against standards derived from the recently published BSR guideline for the management of adults with SLE, the NICE Technology Appraisal for Belimumab, and NHS England{\textquoteright}s Clinical Commissioning Policy for Rituxi-mab. Methods: SLE cases attending outpatient clinics during any 4-week period between February–June 2018 were retro-spectively audited to assess care at the preceding visit. The effect of clinical environment (general vs. dedi-cated CTD/vasculitis clinic and specialised vs. non-specialised centre) were tested. Bonferroni{\textquoteright}s correction was applied to the significance level.Results: 51 units participated. We audited 1021 episodes of care in 1003 patients (median age 48 years, 74% diag-nosed >5 years ago). Despite this disease duration, 286 (28.5%) patients had active disease. Overall 497 (49%) were receiving prednisolone, including 28.5% of patients who had inactive disease. Low documented compliance (<60% clinic visits) was identified for audit standards relating to formal disease-activity assess-ment, reduction of drug-related toxicity and protection against comorbidities and damage. Compared to general clinics, dedicated clinics had higher compliance with standards for appropriate urine protein quantifi-cation (85.1% vs 78.1%, p =< 0.001). Specialised centres had higher compliance with BILAG-BR recruit-ment (89.4% vs 44.4%, p =< 0.001) and blood pressure recording (95.3% vs 84.1%).Conclusions: This audit highlights significant unmet need for better disease control, reduction in corticosteroid toxicity and is an opportunity to improve compliance with national guidelines. Higher performance with nephritis screen-ing in dedicated clinics supports wider adoption of this service-delivery model. ",
keywords = "Systemic lupus erythematosus, Audit, standards of care, health services research",
author = "Pearce, {Fiona A} and Megan Rutter and Ravinder Sandhu and Batten, {Rebecca L} and Rozeena Garner and Jayne Little and Nehal Narayan and Sharp, {Charlotte A} and Bruce, {Ian N} and Nicola Erb and Bridget Griffiths and Hannah Guest and Elizabeth Macphie and Jon Packham and Chris Hiley and Karen Obrenovic and Ali Rivett and Caroline Gordon and Lanyon, {Peter C}",
year = "2020",
month = dec,
day = "8",
doi = "10.1093/rheumatology/keaa759",
language = "English",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - BSR guideline on the management of adults with systemic lupus erythematosus (SLE) 2018

T2 - baseline multi-centre audit in the UK

AU - Pearce, Fiona A

AU - Rutter, Megan

AU - Sandhu, Ravinder

AU - Batten, Rebecca L

AU - Garner, Rozeena

AU - Little, Jayne

AU - Narayan, Nehal

AU - Sharp, Charlotte A

AU - Bruce, Ian N

AU - Erb, Nicola

AU - Griffiths, Bridget

AU - Guest, Hannah

AU - Macphie, Elizabeth

AU - Packham, Jon

AU - Hiley, Chris

AU - Obrenovic, Karen

AU - Rivett, Ali

AU - Gordon, Caroline

AU - Lanyon, Peter C

PY - 2020/12/8

Y1 - 2020/12/8

N2 - Objectives: To assess the baseline care provided to patients with SLE attending UK Rheumatology units, audited against standards derived from the recently published BSR guideline for the management of adults with SLE, the NICE Technology Appraisal for Belimumab, and NHS England’s Clinical Commissioning Policy for Rituxi-mab. Methods: SLE cases attending outpatient clinics during any 4-week period between February–June 2018 were retro-spectively audited to assess care at the preceding visit. The effect of clinical environment (general vs. dedi-cated CTD/vasculitis clinic and specialised vs. non-specialised centre) were tested. Bonferroni’s correction was applied to the significance level.Results: 51 units participated. We audited 1021 episodes of care in 1003 patients (median age 48 years, 74% diag-nosed >5 years ago). Despite this disease duration, 286 (28.5%) patients had active disease. Overall 497 (49%) were receiving prednisolone, including 28.5% of patients who had inactive disease. Low documented compliance (<60% clinic visits) was identified for audit standards relating to formal disease-activity assess-ment, reduction of drug-related toxicity and protection against comorbidities and damage. Compared to general clinics, dedicated clinics had higher compliance with standards for appropriate urine protein quantifi-cation (85.1% vs 78.1%, p =< 0.001). Specialised centres had higher compliance with BILAG-BR recruit-ment (89.4% vs 44.4%, p =< 0.001) and blood pressure recording (95.3% vs 84.1%).Conclusions: This audit highlights significant unmet need for better disease control, reduction in corticosteroid toxicity and is an opportunity to improve compliance with national guidelines. Higher performance with nephritis screen-ing in dedicated clinics supports wider adoption of this service-delivery model.

AB - Objectives: To assess the baseline care provided to patients with SLE attending UK Rheumatology units, audited against standards derived from the recently published BSR guideline for the management of adults with SLE, the NICE Technology Appraisal for Belimumab, and NHS England’s Clinical Commissioning Policy for Rituxi-mab. Methods: SLE cases attending outpatient clinics during any 4-week period between February–June 2018 were retro-spectively audited to assess care at the preceding visit. The effect of clinical environment (general vs. dedi-cated CTD/vasculitis clinic and specialised vs. non-specialised centre) were tested. Bonferroni’s correction was applied to the significance level.Results: 51 units participated. We audited 1021 episodes of care in 1003 patients (median age 48 years, 74% diag-nosed >5 years ago). Despite this disease duration, 286 (28.5%) patients had active disease. Overall 497 (49%) were receiving prednisolone, including 28.5% of patients who had inactive disease. Low documented compliance (<60% clinic visits) was identified for audit standards relating to formal disease-activity assess-ment, reduction of drug-related toxicity and protection against comorbidities and damage. Compared to general clinics, dedicated clinics had higher compliance with standards for appropriate urine protein quantifi-cation (85.1% vs 78.1%, p =< 0.001). Specialised centres had higher compliance with BILAG-BR recruit-ment (89.4% vs 44.4%, p =< 0.001) and blood pressure recording (95.3% vs 84.1%).Conclusions: This audit highlights significant unmet need for better disease control, reduction in corticosteroid toxicity and is an opportunity to improve compliance with national guidelines. Higher performance with nephritis screen-ing in dedicated clinics supports wider adoption of this service-delivery model.

KW - Systemic lupus erythematosus

KW - Audit

KW - standards of care

KW - health services research

U2 - 10.1093/rheumatology/keaa759

DO - 10.1093/rheumatology/keaa759

M3 - Article

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

ER -