TABLE 2:
PERFORMANCE ON QUALITY MEASURES (QM)
| LUPUS CLINIC |
GENERAL RHEUMATOLOGY CLINIC |
P- Value |
||||||
|---|---|---|---|---|---|---|---|---|
| QM No. |
Description of QM | QM eligible (N) |
Met QM (n) |
PP (%) |
QM eligible (N) |
Met QM (n) |
PP (%) |
|
| 1 (CR) | ANA, CBC, Platelet, Creatinine, UA at diagnosis of lupus | 77 | 77 | 100 | 73 | 72 | 98.6 | 0.49 |
| 2 (CR) | AntidsDNA, C3/4, APL within 6 months of diagnosis | 77 | 55 | 71.4 | 73 | 27 | 37.0 | <0.001 |
| 3 (CR+PS) | Counselling for use of sunscreen | 77 | 76 | 98.7 | 73 | 61 | 83.6 | 0.001 |
| 4 (CR+PS) | Infleunza vaccine in last year if on ISM | 46 | 45 | 97.8 | 43 | 38 | 88.4 | 0.1 |
| 5 (CR+PS) | Pneumococcal vaccine if on ISM | 46 | 39 | 84.8 | 43 | 21 | 48.8 | <0.001 |
| 6 (CR+PS) | DEXA if have received ≥7.5 mg/day CS for ≥3 months | 52 | 49 | 94.2 | 44 | 24 | 54.5 | <0.001 |
| 7 (CR+PS) | Calcium and Vitamin D if have received ≥7.5 mg/d CS for ≥3 months or is post-menopausal | 59 | 46 | 78 | 57 | 41 | 71.9 | 0.45 |
| 8 (CR+PS) | Antiresorptive agent if have received ≥7.5 mg/d CS for ≥1 month & central T score ≤2.5 or h/o fragility fracture | 12 | 12 | 100 | 7 | 7 | 100 | N\A |
| 9 (CR+PS) | Counselling about risks/benefits of new medication | 77 | 71 | 92.2 | 73 | 59 | 80.8 | 0.04 |
| 10 (CR) | Baseline tests at initiation of drugs | 74 | 73 | 98.6 | 72 | 67 | 93.1 | 0.11 |
| 11 (CR) | Monitoring for drug toxicity | 73 | 66 | 90.4 | 69 | 60 | 87 | 0.6 |
| 12 (CR+PS) | Steroid sparing agent if have taken ≥10 mg/day CS for ≥3 months | 46 | 46 | 100 | 37 | 30 | 81.1 | 0.002 |
| 13 (CR) | Follow up tests (UA, CBC, Creatinine) done for LN at every 3 months | 19 | 14 | 73.7 | 10 | 6 | 60 | 0.68 |
| 14 (CR) | Treatment with ISM & CS within 1 month of diagnosis of Class 3/4 LN | 13 | 13 | 100 | 14 | 14 | 100 | N\A |
| 15 (CR) | Antihypertensive if have proteinuria ≥ 300 mg/d or GFR < 60 ml/min & ≥ 2 BP readings > 130/80 | 15 | 14 | 93.3 | 15 | 15 | 100 | 1.00 |
| 16 (CR+PS) | ACE inhibitor or ARB if have proteinuria ≥ 300 mg/d | 18 | 17 | 94.4 | 12 | 7 | 58.3 | 0.03 |
| 17 (CR+PS) | Assessment of CVD risk & counseling | 77 | 31 | 40.3 | 73 | 11 | 15.1 | 0.01 |
| 18 (CR) | Tests in pregnancy (AntiSSA/SSB, APL) | 9 | 6 | 66.7 | 7 | 2 | 28.6 | 0.32 |
| 19 (CR) | Treatment of APS in future pregnancies | 1 | 1 | 100 | 1 | 1 | 100 | N\A |
| 20 (CR+PS) | Reproductive health counseling | 29 | 26 | 89.7 | 20 | 13 | 65.0 | 0.07 |
Abbreviations: PP - Performance percentage, ANA - Antinuclear antibody, CBC - Complete Blood Count, UA - Urinalysis, APL - Anti- phospholipid antibodies, ISM - Immunosuppressive medications, CS - Corticosteroids, HCQ - Hydroxychloroquine, MTX - Methotrexate, MMF - Mycophenolate mofetill, LN - Lupus Nephritis, ACE – Angiotensin converting enzyme, ARB - Angiotensin receptor blocker, CVD – Cardiovascular Disease, APS - Antiphospholipid antibody syndrome.