Assessing and improving communication strategies among healthcare providers and African American individuals with systemic lupus: a scoping review.

BACKGROUND

Systemic Lupus Erythematosus (SLE) is a severe autoimmune disorder that impacts multiple organ systems, with African American (AA) adults having worse outcomes and poor prognoses compared to other ethnic groups. Ineffective patient-provider communication and inadequate screening for modifiable risk factors contribute to poorer SLE outcomes and ongoing health disparities. This scoping review evaluated the influence of patient-provider communication among adults with SLE, with particular attention to implications for African American populations, to inform the development of strategies to mitigate SLE health disparities.

METHODS

An electronic search was conducted using PubMed, CINAHL, Embase and PsycINFO databases to systematically identify published literature between 2012 and mid-2025. Studies were eligible (1) if participants included African American adults (over 18 years old) with a diagnosis of SLE or included a sample with ≥ 50% African American representation, (2) were published in the English language, (3) reported databased original research results, and (4) reported findings related to patient-provider communication, a communication tool, or a communication strategy either independently or in conjunction with health outcomes.

RESULTS

Search results yielded 214 articles. After an in-depth screening process using the PRISMA method, 20 articles met both inclusion and exclusion criteria: seven qualitative, six quantitative, and seven mixed methods. Two studies enrolled exclusively African American participants. A central theme was the importance of embedding effective communication strategies into evidence-based decision aids for individuals with SLE. Additional priorities included identifying key facilitators of communication, such as family involvement, slower speech, and empathy, followed by the need to validate patient-reported outcome measures that support better information exchange. Nevertheless, none of the studies examined targeted communication tools aimed at reducing modifiable risk factors or improving health outcomes among African Americans with SLE, indicating a critical gap warranting further investigation.

CONCLUSIONS

Research on effective patient-provider communication with African American adults living with SLE is limited and lacks evaluation of specific communication strategies. Findings demonstrated that effective communication, marked by trust, clarity, and adequate appointment duration positively influence the clinical experiences of African American adults with SLE.

CLINICAL TRIAL NUMBER: Not applicable.