Addressing Racial, Ethnic Disparities in RA and SLE Disease Outcomes

Black and Hispanic patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) disproportionately experience worse outcomes compared to Whites, according to a study presented at ACR Convergence 2021, the American College of Rheumatology’s annual meeting.

Working toward equitable health care access and disease outcomes should be one of the foremost priorities for pharmacists and other health care professionals. By examining the various social determinants of health (SDOH)—including a patient’s neighborhood and built environment—researchers can ascertain effective methods for improving health care access and quality for all patients, regardless of race or ethnicity.

In the current study, researchers aimed to investigate the relationship between living in a disadvantaged neighborhood, race/ethnicity, and the frequency of being prescribed disease-specific treatment for RA or SLE.From January through September 2020, investigators used the electronic medical record (EMR) at a large urban hospital to collect data on age, insurance information, address with zip code, race/ethnicity, and sex. The study also incorporated area deprivation index scores. Investigators compared prescribed biologic agents or conventional disease modifying rheumatic drugs (DMARDs) between racial/ethnic groups, as well as prescriptions of steroids, non-steroidal medications, and opiates.

The study cohort included a total of 1326 patients: 859 with RA and 457 with SLE, 181 who identified as non-Hispanic White, 671 who identified as non-Hispanic Black, and 347 who identified as Hispanic. Area deprivation index scores were higher among Black and Hispanic patients compared with White patients for both RA and SLE (p < 0.00001 RA and SLE). Researchers also reported that minority patients with RA were more likely to have Medicaid health insurance than Whites (p < 0.00005 RA; p < 0.59 SLE).

The data did not show a pattern between physician prescribing patterns and area deprivation index scores (p < 0.989 RA; p < 0.08 SLE), investigators found.

“Future studies with larger sample sizes are needed to help quantify the relationships between area deprivation scores and insurance in order to better understand physician prescribing patterns in patients, particularly among minority groups living in these areas, and to understand how these factors may influence disease-related health outcomes in RA and SLE,” the authors concluded.

Reference

1. Berry J, Galanter W, Welsh A, et al. Racial/ethnic disparities in prescription medications in a large urban medical center. Presented at: ACR Convergence 2021; November 3-9, 2021. Abstract 0613.