{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T17:27:34Z","timestamp":1794072454986,"version":"4.8.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"14","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the operational criteria and characterize the referral outcomes of a structured primary care\u2013led clinical triage pathway for systemic lupus erythematosus (SLE), implemented by a family physician with postgraduate training in rheumatology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study including 148 adult patients with confirmed SLE managed between January 2025 and January 2026 at SERVIMED IPS, Colombia. The structured triage pathway was in active clinical use throughout the study period. For the purposes of this analysis, patients were classified into a four-level triage framework with predefined clinical and laboratory criteria for each management tier (continued primary care, programmed referral, prioritized referral, and urgent referral) by applying those criteria retrospectively to documented clinical and laboratory records. Primary outcomes included time to rheumatology assessment and indications for referral.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 148 patients (84.5% female; median age 38\u00a0years), 93 (62.8%) required rheumatology consultation (38 programmed, 55 prioritized) and 19 (12.8%) required urgent referral. Median time to rheumatology assessment was 22\u00a0days (IQR 15\u201331) for prioritized and 49\u00a0days (IQR 38\u201362) for programmed referrals. Urgent referrals were evaluated within a median of 2\u00a0days (IQR 1\u20133). Newly diagnosed patients were more frequently classified at Level 3 than established patients (56.5% vs 28.4%). Triage reclassification occurred in a minority of cases. SLEDAI-2K was available in 92 patients (median 6, IQR 4\u201310).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A structured primary care\u2013led triage pathway with explicit operational criteria provides a descriptive framework for risk-stratified referral to rheumatology care for patients with SLE in resource-constrained settings. The observed referral times are preliminary descriptive findings that warrant prospective comparative evaluation. Formal inter-rater reliability assessment and independent validation studies are needed before broader implementation recommendations can be made.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033261484768","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T15:01:52Z","timestamp":1787929312000},"page":"1537-1542","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A structured primary care\u2013led triage and referral pathway for systemic lupus erythematosus: Operational criteria and referral outcomes from a real-world rheumatology practice"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4742-0403","authenticated-orcid":false,"given":"Juan Sebasti\u00e1n","family":"Ther\u00e1n","sequence":"first","affiliation":[{"name":"Clinical Research Department, SERVIMED Clinical Research Center, Bucaramanga, Colombia"},{"name":"Universidad de Santander (UDES)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s Felipe","family":"Otero Rueda","sequence":"additional","affiliation":[{"name":"Clinical Research Department, SERVIMED Clinical Research Center, Bucaramanga, Colombia"},{"name":"Universidad de Santander (UDES)"},{"name":"School of Medicine, Universidad de Ciencias Medicas de La Habana, Havana, Cuba"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214819"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215089"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30546-X"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20648"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.40674"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2008.10.007"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.38981"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22182"},{"key":"e_1_3_8_10_2","doi-asserted-by":"crossref","unstructured":"Battafarano DF Ditmyer M Bolster MB et al. 2015 American College of Rheumatology workforce study: supply and demand projections of adult rheumatology workforce 2015-2030. Arthritis Care Res (Hoboken) 2018;70(4):617-626. https:\/\/doi.org\/10.1002\/acr.23518","DOI":"10.1002\/acr.23518"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.38323"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaceta.2011.10.009"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201063"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0040296"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31363-1"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001180"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033261484768","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033261484768","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033261484768","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T17:23:13Z","timestamp":1794072193000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033261484768"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":15,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2026,12]]}},"alternative-id":["10.1177\/09612033261484768"],"URL":"https:\/\/doi.org\/10.1177\/09612033261484768","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]}}}