TY - JOUR
T1 - Development of a Set of Lupus-Specific, Ambulatory Care–Sensitive, Potentially Preventable Adverse Conditions
T2 - A Delphi Consensus Study
AU - Feldman, Candace H.
AU - Speyer, Cameron
AU - Ashby, Rachel
AU - L. Bermas, Bonnie
AU - Bhattacharyya, Shamik
AU - Chakravarty, Eliza
AU - Everett, Brendan
AU - Ferucci, Elizabeth
AU - Hersh, Aimee O.
AU - Marty, Francisco M.
AU - Merola, Joseph F.
AU - Ramsey-Goldman, Rosalind
AU - Rovin, Brad H.
AU - Son, Mary Beth
AU - Tarter, Laura
AU - Waikar, Sushrut
AU - Yazdany, Jinoos
AU - Weissman, Joel S.
AU - Costenbader, Karen H.
N1 - Publisher Copyright:
© 2019, American College of Rheumatology
PY - 2021/1
Y1 - 2021/1
N2 - Objective: Individuals with systemic lupus erythematosus (SLE) are at high risk for infections and SLE- and medication-related complications. The present study was undertaken to define a set of SLE-specific adverse outcomes that could be prevented, or their complications minimized, if timely, effective ambulatory care had been received. Methods: We used a modified Delphi process beginning with a literature review and key informant interviews to select initial SLE-specific potentially preventable conditions. We assembled a panel of 16 nationally recognized US-based experts from 8 subspecialties. Guided by the RAND-UCLA Appropriateness Method, we held 2 survey rounds with controlled feedback and an interactive webinar to reach consensus regarding preventability and importance on a population level for a set of SLE-specific adverse conditions. In a final round, the panelists endorsed the potentially preventable conditions. Results: Thirty-five potential conditions were initially proposed; 62 conditions were ultimately considered during the Delphi process. The response rate was 100% for both survey rounds, 88% for the webinar, and 94% for final approval. The 25 SLE-specific conditions meeting consensus as potentially preventable and important on a population level fell into 4 categories: vaccine-preventable illnesses (6 conditions), medication-related complications (8 conditions), reproductive health–related complications (6 conditions), and SLE-related complications (5 conditions). Conclusion: We reached consensus on a diverse set of adverse outcomes relevant to SLE patients that may be preventable if patients receive high-quality ambulatory care. This set of outcomes may be studied at the health system level to determine how to best allocate resources and improve quality to reduce avoidable outcomes and disparities among those at highest risk.
AB - Objective: Individuals with systemic lupus erythematosus (SLE) are at high risk for infections and SLE- and medication-related complications. The present study was undertaken to define a set of SLE-specific adverse outcomes that could be prevented, or their complications minimized, if timely, effective ambulatory care had been received. Methods: We used a modified Delphi process beginning with a literature review and key informant interviews to select initial SLE-specific potentially preventable conditions. We assembled a panel of 16 nationally recognized US-based experts from 8 subspecialties. Guided by the RAND-UCLA Appropriateness Method, we held 2 survey rounds with controlled feedback and an interactive webinar to reach consensus regarding preventability and importance on a population level for a set of SLE-specific adverse conditions. In a final round, the panelists endorsed the potentially preventable conditions. Results: Thirty-five potential conditions were initially proposed; 62 conditions were ultimately considered during the Delphi process. The response rate was 100% for both survey rounds, 88% for the webinar, and 94% for final approval. The 25 SLE-specific conditions meeting consensus as potentially preventable and important on a population level fell into 4 categories: vaccine-preventable illnesses (6 conditions), medication-related complications (8 conditions), reproductive health–related complications (6 conditions), and SLE-related complications (5 conditions). Conclusion: We reached consensus on a diverse set of adverse outcomes relevant to SLE patients that may be preventable if patients receive high-quality ambulatory care. This set of outcomes may be studied at the health system level to determine how to best allocate resources and improve quality to reduce avoidable outcomes and disparities among those at highest risk.
UR - http://www.scopus.com/inward/record.url?scp=85086649416&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086649416&partnerID=8YFLogxK
U2 - 10.1002/acr.24095
DO - 10.1002/acr.24095
M3 - Article
C2 - 31628721
AN - SCOPUS:85086649416
SN - 2151-464X
VL - 73
SP - 146
EP - 157
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 1
ER -