Transportation among top social determinants of health for adults with lupus nephritis
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Key takeaways:
- Young African American women with lupus nephritis said transportation, copays and adherence support were top barriers to care.
- Help navigating the health system was an important concern.
SAN DIEGO — Help with transportation, copays and treatment adherence were the top three needs affecting health care according to a group of patients participating in a lupus navigator pilot program.
“Social determinants of health are a major barrier for appropriate care for patients with systemic lupus erythematosus,” Abdallah Sassine Geara, MD, associate professor of clinical medicine (renal-electrolyte and hypertension) and clinical director of the glomerular diseases program at the University of Pennsylvania, told Healio. “This pilot morphed into an institutionally sponsored intervention by employing a social worker focused on systemic lupus erythematosus/lupus nephritis.”
Geara and colleagues piloted a lupus navigator program in the rheumatology and nephrology divisions of an outpatient academic setting. From July 2022 to December 2023, the clinical care team worked with volunteer community health workers and college students to engage with patients to identify and address social determinants of health. Among the patients, 86% were young women, 89% identified as African American and 86% had lupus nephritis.
First, physicians identified 67 patients with high need based on their medical history, ability to maintain their treatment plan and their social setting. The identified patients completed a survey administered by college student volunteers, and after review, the care team designed and implemented individualized interventions.
The most often identified barriers were visit copay, adherence, transportation and medication copay, according to the researchers. Most often mentioned as a respondent’s most important concern were transportation, visit copy and navigating the health system.
Regarding interventions, 30% of participants received direct financial support, 28% were referred to social services, 18% were provided with medical supplies, 15% were referred to education and group support and 9% were referred back to the clinical team.
“Our systemic lupus erythematosus/lupus nephritis outcomes will not improve unless we start modifying our care and integrating social determinants of health into our assessment and care plan,” Geara said.
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Geara AS, et al. TH-PO667. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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