{
  "abstract": "Objectives Social determinants of health (SDH) influence outcomes in systemic lupus erythematosus (SLE), yet remain rarely captured in care or research. Because vulnerabilities differ across healthcare, socioeconomic and cultural contexts, LUPUS-ALERT (Systemic Lupus Erythematosus globAL contExt scReening Tool) was conceived as a globally co-developed initiative between patients and healthcare professionals (HCPs) to create a structured screening instrument identifying social, economic, psychosocial, and structural vulnerabilities impacting SLE outcomes. This abstract summarises Steps 1–3 of the four-step development process and explores differences between patient and HCP perspectives.Methods Between 2024 and 2025, 126 participants (63 HCPs, 63 patients/patient representatives) from Europe (65.1%), Africa (17.4%), the Americas (11.1%), and Asia-Pacific (6%) completed successive online surveys defining vulnerabilities, rating their relevance (1–9 scale), and indicating who should assess them ( figure 1).Results Step 1 generated 1,466 open-ended suggestions for potential SLE vulnerabilities. After excluding non-vulnerabilities and duplicates, 37 unique pooled items were identified. The most frequent were ‘limited access to healthcare’ (138 by HCPs and 93 by patients), ‘economic insufficiency’ (132 and 71), and ‘low health literacy’ (71 and 30). In Step 2, all domains were rated important (median >=7, from 1 to 9), except ‘addiction that affects SLE care’. The highest-rated were ‘limited access to healthcare’ and ‘inability to afford care’ (median 9 [IQR 8-9]). Agreement between groups was strong, yet 12 domains differed significantly. Patients rated healthcare system ‘insufficiency outside of medical appointment’ and ‘integration’, ‘communication’, ‘autonomy’, ‘mental health’, ‘fatigue’, ‘discrimination’, ‘job insecurity’, and ‘social support’ significantly higher; HCPs rated ‘availability and access to required health services’ higher. In step 3, most domains were recommended for patient assessment. ‘Denial of SLE’, ‘mental health’, ‘cognitive impairment’, ‘low literacy’, ‘low adherence’, and ‘autonomy’ were selected for dual assessment. HCPs assigned ‘safety of the environment’ to patient self-assessment.Abstract PO:07:193 Figure 1Conclusions LUPUS-ALERT is the first globally co-developed initiative to systematically assess vulnerabilities shaping SLE outcomes. Patients and HCPs largely converge in recognising key domains but differ in emphasis: patients prioritise psychosocial and support-related aspects, whereas HCPs stress system-level barriers. These findings directly inform construction of the LUPUS-ALERT screening questionnaire and underscore the value of collaboratively designed tools for equitable lupus care.",
  "authors": [
    {
      "affiliations": [
        "UDAI – Autoimmune Disease Unit, ULS Tâmega e Sousa, Penafiel, Portugal",
        "UMIB – Unit for Multidisciplinary Research in Biomedicine, ICBAS School of Medicine, University of Porto, Porto, Portugal",
        "i3S – Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal"
      ],
      "name": "Daniel Guimarães De Oliveira"
    },
    {
      "affiliations": [
        "Lupus Europe, Brussels, BELGIUM"
      ],
      "name": "Zoe Karakikla-Mitsakou"
    },
    {
      "affiliations": [
        "Department of Rheumatology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France"
      ],
      "name": "Laurent Arnaud"
    }
  ],
  "title": "PO:07:193 LUPUS-ALERT: global co-development of a screening tool for social determinants and vulnerabilities in systemic lupus erythematosus",
  "uid": "5c5a4477-317f-5a32-89d4-2990122c65f9"
}