Featured Research

from universities, journals, and other organizations

Life challenges prevent those with lupus from keeping doctors' appointments

Date:
November 6, 2011
Source:
Hospital for Special Surgery
Summary:
The first step towards successful medical care is to see a physician, but for some patients this isn't as simple or easy as it may sound. A new study finds that many lupus patients with low socioeconomic status are unable to attend scheduled appointments with physicians due to daily obstacles.

The first step towards successful medical care is to see a physician, but for some patients this isn't as simple or easy as it may sound.

A study being presented Nov. 6 at the 2011 Annual Scientific Meeting of the American College of Rheumatology in Chicago, finds that many lupus patients with low socioeconomic status are unable to attend scheduled appointments with physicians due to daily obstacles.

"Lupus is a systemic autoimmune disease that requires continuous monitoring of the disease activity and the effects medications may be having on someone," explained Doruk Erkan, M.D., senior author, rheumatologist and clinical co-director at the Mary Kirkland Center for Lupus Care at Hospital for Special Surgery. "Missing an appointment, and thus staying on a medical course without re-evaluating a patient's health status, could cause these individuals avoidable harm."

The researchers examined lupus patients who also had low socioeconomic status at the Mary Kirkland Center for Lupus Care at Hospital for Special Surgery, and found that challenges of socioeconomic status played a large part in causing some of the patients to miss their appointments. The top two reasons for missing their appointment was due to tardy or unreliable transportation, such as ambulettes, or because of insufficient childcare.

"Most of these lupus patients are women," explained Pretima Persad, MPH, lead author of the study and the manager of the Mary Kirkland Center for Lupus Care. "If their childcare falls through, they put their child first and decide to cancel appointments, which can then affect their healthcare."

During the first phase of the study, the research team studied 143 patients and categorized these individuals into three classes, based on the number of appointments they missed. They found that seven patients were "poor" attendees -- attending only 1-30 percent of their appointments; 66 patients were "average" attendees -- attending 31-70 percent of their appointments; and 71 patients were "good" attendees -- attending 71-100 percent of their appointments. After excluding the "poor" group from their calculations, because there were too few to be statistically significant, the researchers found that the "average" and "good" attendees had an overall appointment compliance rate of 67 percent.

During the second phase of the study, for the purpose of improving the appointment compliance rate among these patients, motivational, reminder phone calls were made the day prior to their appointments. After this intervention, 69 percent of patients attended their appointments, which showed that the reminder-call had no statistically significant effect on behavior.

"This proved that these patients weren't missing their appointments because of forgetfulness, and shows that there are other factors that prevented them from arriving on the day of their appointment that they could not predict," explained Persad.

After following up with patients who missed their appointments, the researchers found that 44 percent of these individuals cited transportation, and 19 percent claimed that child care were the top two reasons for missing their appointments.

"From this study, we now can say that these patients have social obstacles that are the real issue, it's not that they are forgetful, or that they do not take their own medical care seriously," said Dr. Erkan. "Improving transportation services or temporary childcare for these patients is potentially an important approach to ensure that this patient population receives the attentive care they need and deserve."

A common and potentially dangerous health concern for these individuals is kidney inflammation, because, in lupus patients, the body's own immune system may attack different organs including kidneys. If not monitored regularly, someone with lupus might be faced with kidney malfunction without experiencing any pain. Regular urine and blood testing, at least every three months in patients who are deemed by their rheumatologist to have relatively active lupus, is important to monitor kidney involvement, explained Kyriakos A. Kirou, M.D., DSc, FAC, co-author of the study and clinical co-director at the Mary Kirkland Center for Lupus Care at Hospital for Special Surgery.

"It's possible that these patients are doing fine, but it's also possible that they are getting sick internally, without having any significant symptoms," explained Dr. Kirou. "They could be in dire need of medical attention without knowing it."

The Mary Kirkland Center for Lupus Care provides lupus patients with comprehensive, multidisciplinary assessments, support programs and access to clinical trials. For more about the center, please visit www.hss.edu/lupuscenter.


Story Source:

The above story is based on materials provided by Hospital for Special Surgery. Note: Materials may be edited for content and length.


Cite This Page:

Hospital for Special Surgery. "Life challenges prevent those with lupus from keeping doctors' appointments." ScienceDaily. ScienceDaily, 6 November 2011. <www.sciencedaily.com/releases/2011/11/111106151159.htm>.
Hospital for Special Surgery. (2011, November 6). Life challenges prevent those with lupus from keeping doctors' appointments. ScienceDaily. Retrieved April 19, 2014 from www.sciencedaily.com/releases/2011/11/111106151159.htm
Hospital for Special Surgery. "Life challenges prevent those with lupus from keeping doctors' appointments." ScienceDaily. www.sciencedaily.com/releases/2011/11/111106151159.htm (accessed April 19, 2014).

Share This



More Health & Medicine News

Saturday, April 19, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

'Holy Grail' Of Weight Loss? New Find Could Be It

'Holy Grail' Of Weight Loss? New Find Could Be It

Newsy (Apr. 18, 2014) In a potential breakthrough for future obesity treatments, scientists have used MRI scans to pinpoint brown fat in a living adult for the first time. Video provided by Newsy
Powered by NewsLook.com
Little Progress Made In Fighting Food Poisoning, CDC Says

Little Progress Made In Fighting Food Poisoning, CDC Says

Newsy (Apr. 18, 2014) A new report shows rates of two foodborne infections increased in the U.S. in recent years, while salmonella actually dropped 9 percent. Video provided by Newsy
Powered by NewsLook.com
Scientists Create Stem Cells From Adult Skin Cells

Scientists Create Stem Cells From Adult Skin Cells

Newsy (Apr. 17, 2014) The breakthrough could mean a cure for some serious diseases and even the possibility of human cloning, but it's all still a way off. Video provided by Newsy
Powered by NewsLook.com
Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins