Identifying High-Impact Solutions to Address Racial and Ethnic Health Disparities in Lupus: A Consensus-Based Approach.

Abstract

We conducted formative research aimed at identifying solutions that address inequitable health outcomes in lupus due to adverse social determinants of health (SDoH). We conducted a search for keywords, which provided insights into potential solutions and initiatives underway. An advisory panel of lupus experts iteratively reviewed the list of literature-scoped solutions in working sessions, filling knowledge gaps, which allowed for further defining and classifying solutions based on area of focus, feasibility, and impact. Seven-in-depth semistructured discussions and a modified Delphi survey approach were leveraged to align the advisory panel based on feasibility, impact, and costs of the proposed solutions. Thirty-three solutions were identified and classified into four key categories: financial safety net, patient education and shared decision-making, physician education, and other solutions. High-impact solutions that were prioritized included the following: "collecting granular information like patient-reported outcomes to provide personalized care and accelerate development of new products," "expanding Medicaid coverage via infrastructure," and "supporting people living with lupus in applying and getting approval for disability." Addressing health and health care disparities linked to negative SDoH is a key goal in the management of lupus, as disparities in outcomes can be stark. Increasing the visibility of potential solutions and aligning the community on top priorities can enable more efficient and effective contributions to health care equity and ultimately better health outcomes for people living with lupus.