Quality indicator | SLC N (%) | HRC N (%) | PRC N (%) | p value |
---|---|---|---|---|
Diagnostic work-up | ||||
 Suspected diagnosis work-up (US) | 50/50 (100.0%) | 56/56 (100.0%) | 55/55 (100.0%) | – |
 New diagnosis tests (US) | 50/50 (100.0%) | 56/56 (100.0%) | 50/55 (90.9%) | 0.007 |
 Autoantibodies at diagnosis (EU) | 50/50 (100.0%) | 56/56 (100.0%) | 54/55 (98.2%) | 0.38 |
Disease and comorbidities assessment | ||||
 Assessment of disease activity at each visit (EU) | 147/147 (100.0%) | 0/56 (0.0%) | 0 /55 (0.0%) | <0.001 |
 Assessment of disease damage at each visit (EU) | 141/147 (95.9%) | 0/56 (0.0%) | 0/55 (0.0%) | <0.001 |
 Evaluation of quality of life at each visit (EU) | 0/147 (0.0%) | 0/56 (0.0%) | 0/55 (0.0%) | – |
 Record comorbidities at least once a year (EU) | 147/147 (100.0%) | 52/56 (92.9%) | 50/55 (90.9%) | 0.002 |
 Monitoring tests every six months (EU) | 132/147 (89.8%) | 54/56 (96.4%) | 22/55 (40.0%) | <0.001 |
 Assessment of cardiovascular risk factors (US) | 91/147 (61.9%) | 14/56 (25.0%) | 8/55 (14.6%) | <0.001 |
 Three monthly tests if evidence of renal disease (US) | 43/44 (97.7%) | 15/16 (93.8%) | 2/2 (100.0%) | 0.50 |
 Treatment within one month of diagnosis of proliferative lupus nephritis (US) | 43/43 (100.0%) | 12/12 (100.0%) | 3/3 (100.0%) | – |
 Anti-hypertensive treatment in lupus renal disease (US) | 22/22 (100.0%) | 5/5 (100.0%) | – | – |
 ACEI/ARB treatment if proteinuria (US) | 42/44 (95.5%) | 7/10 (70.0%) | – | 0.01 |
Medications | ||||
 Assessment for drug toxicity at each visit (EU) | 141/147 (95.9%) | 43/56 (76.8%) | 44/54 (81.5%) | <0.001 |
 Ophthalmologic review if on hydroxychloroquine as per guidelines (EU) | 46/103 (44.7%) | 11/34 (32.4%) | 27/38 (71.1%) | 0.003 |
 Ophthalmologic review if on glucocorticoids as per guidelines (EU) | 34/67 (50.8%) | 5/22 (22.7%) | 16/23 (69.6%) | 0.007 |
 Hepatitis B and C and tuberculosis testing prior to starting immunosuppression (EU) | 59/95 (62.1%) | 19/41 (46.3%) | 9/28 (32.1%) | 0.01 |
 Counselling when prescribed new medications (US) | 118/139 (84.9%) | 14/48 (29.2%) | 26/44 (59.1%) | <0.001 |
 Baseline studies when prescribed new medications (US) | 139/139 (100.0%) | 45/45 (100.0%) | 44/44 (100.0%) | – |
 Monitoring tests for established medications (US) | 143/145 (98.6%) | 51/51 (100.0%) | 50/52 (96.1%) | 0.28 |
 Attempt to taper prednisolone if >10 mg for >3 months (US) | 75/75 (100.0%) | 22/22 (100.0%) | 15/15 (100.0%) | – |
 Bone mineral density testing if received prednisolone >7.5 mg for >3 months (US) | 100/106 (94.3%) | 30/31 (96.8%) | 18/23 (78.3%) | 0.02 |
 Calcium and vitamin D if received prednisolone >7.5 mg for >3 months (US) | 93/105 (88.6%) | 27/31 (87.1%) | 22/24 (91.7%) | 0.86 |
 Osteoporosis treatment (US) | 18/20 (90.0%) | 11/12 (91.7%) | 9/9 (100.0%) | 0.63 |
Preventative care | ||||
 All patients should be vaccinated against influenza and pneumococcus (EU) | 34/147 (23.1%) | 1/55 (1.8%) | 2/55 (3.6%) | <0.001 |
 Influenza vaccination if on immunosuppressants (US) | 64/96 (66.7%) | 5/46 (10.9%) | 2/36 (5.6%) | <0.001 |
 Pneumococcal vaccination if on immunosuppressants (US) | 21/96 (21.9%) | 1/46 (2.2%) | 1/34 (2.9%) | <0.001 |
 Sun avoidance counselling ever (US) | 27/147 (18.4%) | 5/56 (8.9%) | 2/55 (3.6%) | 0.01 |
Reproductive health | ||||
 Ro, La and antiphospholipid antibody testing in pregnancy (US) | 14/14 (100.0%) | 6/6 (100.0%) | 5/5 (100.0%) | – |
 Aspirin and heparin offered for subsequent pregnancies if antiphospholipid syndrome pregnancy complications (US) | 2/2 (100.0%) | 2/2 (100.0%) | 2/2 (100.0%) | – |
 Teratogenic medication risk and contraception counselling in reproductive age women (US) | 42/64 (65.6%) | 4/20 (20.0%) | 6/14 (42.9%) | 0.001 |