Lupus clinic | General Rheumatology clinic | P-value | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
QI No. | Description of QI | QI eligible (N) | Met QI (n) | PP (%) | QI eligible (N) | Met QI (n) | PP (%) | |||||||
1 | ANA, CBC, Platelet, Creatinine, UA at diagnosis of lupus | 60 | 60 | 100 | 40 | 39 | 97.5 | 0.4 | ||||||
2 | AntidsDNA, C3/4, APL within 6 months of diagnosis | 60 | 42 | 70.0 | 40 | 12 | 30.0 | < 0.001 | ||||||
3 | Counselling for use of sunscreen | 60 | 59 | 98.3 | 40 | 35 | 87.5 | 0.036 | ||||||
4 | Influenza vaccine in last year if on ISM | 37 | 36 | 97.3 | 24 | 20 | 83.3 | 0.07 | ||||||
5 | Pneumococcal vaccine if on ISM | 37 | 32 | 86.5 | 24 | 12 | 50.0 | 0.003 | ||||||
6 | DEXA if have received ≥7.5 mg/day CS for ≥3 months | 42 | 40 | 95.2 | 25 | 12 | 48.0 | < 0.001 | ||||||
7 | Calcium and Vitamin D if have received ≥7.5 mg/d CS for ≥3 months or is post-menopausal | 45 | 38 | 84.4 | 31 | 22 | 71.0 | 0.25 | ||||||
8 | Antiresorptive agent if have received ≥7.5 mg/d CS for ≥1 month & central T score ≤ 2.5 or h/o fragility fracture | 10 | 10 | 100 | 3 | 3 | 100 | N\A | ||||||
9 | Counselling about drugs at initiation | 60 | 54 | 90.0 | 40 | 36 | 90.0 | 1.00 | ||||||
10 | Baseline tests at initiation of drugs | 59 | 58 | 98.3 | 40 | 38 | 95.0 | 0.56 | ||||||
11 | Tests for drug monitoring | 59 | 53 | 89.8 | 38 | 33 | 86.8 | 0.74 | ||||||
12 | Steroid sparing agent if have taken ≥10 mg/day CS for ≥3 months | 38 | 38 | 100 | 22 | 18 | 81.8 | 0.007 | ||||||
13 | Follow up tests (UA, CBC, Creatinine) done for LN at every 3 months | 17 | 12 | 70.6 | 7 | 5 | 71.4 | 1.00 | ||||||
14 | Treatment with ISM & CS within 1 month of diagnosis of Class 3/4 LN | 13 | 13 | 100 | 7 | 7 | 100 | N\A | ||||||
15 | Antihypertensive if have proteinuria ≥ 300 mg/d or GFR < 60 ml/min & ≥ 2 BP readings > 130/80 | 14 | 13 | 92.9 | 9 | 9 | 100 | 1.00 | ||||||
16 | ACE inhibitor or ARB if have proteinuria ≥300 mg/d | 15 | 14 | 93.3 | 7 | 4 | 57.1 | 0.07 | ||||||
17 | Assessment of CVD risk & counselling | 60 | 19 | 31.7 | 40 | 7 | 17.5 | 0.16 | ||||||
18 | Tests in pregnancy (AntiSSA/SSB, APL) | 9 | 6 | 66.7 | 5 | 2 | 40.0 | 0.58 | ||||||
19 | Treatment of APS in future pregnancies | 1 | 1 | 100 | 1 | 1 | 100 | N\A | ||||||
20 | Reproductive health counselling | 23 | 20 | 87.0 | 13 | 10 | 76.9 | 0.64 |
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 mofetil,LN – Lupus Nephritis, ARB – Angiotensin receptor blocker, CVD – Cardiovascular Disease, APS – Antiphospholipid antibody syndrome