Lupus and fibromyalgia: Understanding Disparities and Access to Care
Autoimmune diseases such as lupus and fibromyalgia affect millions of people worldwide, but recent studies have shown that these diseases are more common and severe in underrepresented communities, particularly in the Black and Hispanic communities. For instance, lupus is more prevalent in Black patients than in white patients, with an increased risk of complications such as kidney disease, cardiovascular complications, and infectious complications. Fibromyalgia, on the other hand, is more common in patients with lupus, affecting roughly 20-25% of patients with lupus.
Despite the high prevalence of these diseases, patients often face difficulties in accessing medical care due to a combination of factors like cost, access, and lack of awareness. Symptoms such as fatigue, pain, and sleep problems are often dismissed as 'occasional' and not requiring medical attention, but for patients with fibromyalgia, these symptoms are chronic and severely impact their quality of life.
The issue of access to medical care is further compounded by the fact that many patients with lupus and fibromyalgia may experience cognitive impairment, which may affect their ability to seek medical attention. Therefore, it is crucial to address these disparities and increase awareness of these diseases to ensure that patients from all communities receive the care and support they need.
Autoimmune diseases such as lupus and fibromyalgia disproportionately affect underrepresented communities, and access to medical care remains an ongoing issue. By increasing awareness and addressing these disparities, we can ensure that all patients have access to the care and support they need to manage their symptoms and improve their quality of life.
Shortage of Rheumatologists
The shortage of rheumatologists is particularly problematic in Memphis and East Tennessee, where there are few to no rheumatologists available. Patients often travel great distances to Nashville to see rheumatologists. Furthermore, there are very few rheumatologists across the state that accept ten care patients, leaving many patients with no access to care.
To address this issue, the American College of Rheumatology (ACR) is working to expand the number of fellowship slots available to qualified candidates.
Meharry Medical Student Researcher Answers The Call With VUMC Director of Rheumatology & Immunology Divison
Fibromyalgia and lupus are two autoimmune diseases that affect millions of people worldwide, yet much is still unknown about them. Alexandra Lee, a second-year medical student at Meharry Medical College, has a deep interest in rheumatology and fibromyalgia in particular. Her interest in fibromyalgia stems from her mother's diagnosis with the disease, which has made Alexandra acutely aware of the lack of understanding surrounding the condition.
In collaboration with her mentor Leslie Crofford, M.D., Director of Rheumatology & Immunology Division, Alexandra conducted a study that aimed to identify the factors that impact those with lupus, a disease that shares many similarities with fibromyalgia. The study found that social and biological factors impacted memory and cognition in patients with lupus. Additionally, it revealed that fibromyalgia is likely under-diagnosed, especially among minorities.
Alexandra and Dr. Crofford's research was accepted for presentation at the American College of Rheumatology meeting in November 2023. Alexandra presented a poster version of the abstract, which will be published in a medical journal. Her work sheds new light on the impact of fibromyalgia and lupus on patients’ short and long-term memory and to raise awareness about the need for better diagnosis and treatment of fibromyalgia. When analyzing each factor alone for a significant change in RBANS, which they used as their dependent variable to measure cognition, Lee and Dr. Crofford found race, fibromyalgia (based on the polysymptomatic distress scale), and depression (HADS scale) to indicate significance. Essentially, their analysis showed a notable change in both total and immediate memory when patients with lupus also were found to have reported depression, fibromyalgia, and were non-white individuals.
Alexandra's dedication to her work and her commitment to helping others is truly inspiring. Her passion for rheumatology serves as a testament to the importance of research and collaboration in the medical field. With her ongoing efforts and dedicated mentors like Dr. Crofford, Alexandra is sure to make a significant contribution to the field of rheumatology and to the lives of those who suffer from these debilitating diseases.