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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Lupus nephritis (LN) and its treatment is associated with cardiometabolic disease, so there is need to perform regular risk assessment and optimize glycemic and lipid control. We implemented an electronic medical records (EMR)-based physician nudge (Figure 1) and evaluated its impact on glycemic and lipid evaluation among older adults with LN receiving immunosuppressive therapy.
This was a single-center, single-arm, implementation study with a pre-post design. We included patients with biopsy-proven LN and received the physician prompt between July 2022 and June 2024. We included all visits between January 2021 and December 2024 that the patient’s age was ≥40 years old and prescribed immunosuppressants. Demographic and clinical data at 6-monthly intervals (“visits”) were obtained from the EMR. We compared the prevalence of glycemic and lipid evaluation during follow-up visits before and after the intervention using mixed effects logistic regression models to account for variability across patients and physicians and repeated measures over time.
A total of 29 patients with 153 visits were included: 82 visits prior to the intervention and 71 visits after its implementation. The median time from diagnosis to enrolment in the program was 39.2 months (minimum-maximum range: 0.3 to 91.4 months). At the follow-up visits, the median age was 48 (40-80) years old and median eGFR was 89.5 (23.0-122.2) ml/min/1.73 m2. Prednisolone was prescribed at 89.5% of the visits at the median dose of 5 (1-70) mg per day, while mycophenolate mofetil or sodium, calcineurin inhibitor, azathioprine and cyclophosphamide were prescribed at 77.8%, 40.5%, 2.6% and 2.6% of the visits, respectively.
Glycemic evaluation occurred at 43.9% and 64.8% of the pre- and post-intervention visits, respectively. Lipid evaluation occurred at 36.6% and 33.8% of the pre- and post-intervention visits, respectively. Glycemic evaluation was increased during post-intervention visits compared to pre-intervention visits [odds ratio (OR) 2.99 (95% CI: 1.29, 6.89), p=0.01] but lipid evaluation was unchanged [OR 0.72 (95% CI: 0.30, 1.74), p=0.46.
A physician-directed nudge significantly increased glycemic evaluation but not lipid evaluation in older patients with LN treated with immunosuppressants.
