Toby M Maher1, Jeffrey J Swigris2, Michael Kreuter3, Marlies Wijsenbeek4, Nicola Cassidy5, Lucy Ireland6, Judit Axmann7, Steven D Nathan8. 1. Interstitial Lung Disease Unit, Royal Brompton Hospital and Imperial College London, London, United KingdomT.Maher@imperial.ac.uk. 2. National Jewish Health, Denver, Colorado, USA. 3. Center for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Member of the German Center for Lung Research, Heidelberg, Germany. 4. Department of Pulmonary Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 5. Irish Lung Fibrosis Association, Dublin, Ireland. 6. Hall & Partners, London, United Kingdom. 7. F. Hoffmann-La Roche, Ltd., Basel, Switzerland. 8. Inova Fairfax Hospital, Falls Church, Virginia, USA.
Abstract
BACKGROUND: Antifibrotics are recommended for the treatment of individuals with idiopathic pulmonary fibrosis (IPF), but treatment use remains at ∼60%. OBJECTIVE: To investigate the views of individuals with IPF and pulmonologists on the diagnosis and management of IPF to understand treatment patterns. METHODS: Interviews and/or online surveys were completed by patients and pulmonologists from Canada, France, Germany, Italy, Spain, and the UK. Responses from physicians were analyzed by time between diagnosis and treatment initiation in the majority of patients with IPF (group A, > 4 months; group B, ≤4 months). Statistical comparisons between physicians were undertaken using z tests, with p < 0.05 considered statistically significant. RESULTS: The physicians in group A saw fewer patients, were less comfortable discussing the IPF prognosis with patients, and had less belief in the benefits of antifibrotic treatments than the physicians in group B. These physicians' attitudes contrasted with those of the patients, who wanted more information about the IPF prognosis and pharmacological treatment options at diagnosis and were more concerned about preventing disease progression than avoiding medication side effects. Differences between countries were found regarding physicians' comfort in discussing the prognosis at diagnosis and access to care. CONCLUSIONS: Several barriers to antifibrotic treatment, principally reflecting the differing views and values of patients and physicians, were identified in this study, suggesting a need for better patient-physician communication about pharmacological therapy for IPF.
BACKGROUND: Antifibrotics are recommended for the treatment of individuals with idiopathic pulmonary fibrosis (IPF), but treatment use remains at ∼60%. OBJECTIVE: To investigate the views of individuals with IPF and pulmonologists on the diagnosis and management of IPF to understand treatment patterns. METHODS: Interviews and/or online surveys were completed by patients and pulmonologists from Canada, France, Germany, Italy, Spain, and the UK. Responses from physicians were analyzed by time between diagnosis and treatment initiation in the majority of patients with IPF (group A, > 4 months; group B, ≤4 months). Statistical comparisons between physicians were undertaken using z tests, with p < 0.05 considered statistically significant. RESULTS: The physicians in group A saw fewer patients, were less comfortable discussing the IPF prognosis with patients, and had less belief in the benefits of antifibrotic treatments than the physicians in group B. These physicians' attitudes contrasted with those of the patients, who wanted more information about the IPF prognosis and pharmacological treatment options at diagnosis and were more concerned about preventing disease progression than avoiding medication side effects. Differences between countries were found regarding physicians' comfort in discussing the prognosis at diagnosis and access to care. CONCLUSIONS: Several barriers to antifibrotic treatment, principally reflecting the differing views and values of patients and physicians, were identified in this study, suggesting a need for better patient-physician communication about pharmacological therapy for IPF.
Authors: Christopher J Brereton; Timothy Wallis; Michelle Casey; Lynn Fox; Katarina Pontopiddan; Diane Laws; Jennifer Graves; Vanessa Titmuss; Sarah Kearney; Sian Evans; Alison Grove; Samreen Hamid; Luca Richeldi; Katherine M A O'Reilly; Sophie V Fletcher; Mark G Jones Journal: ERJ Open Res Date: 2020-07-20
Authors: Toby M Maher; Michael Kreuter; David J Lederer; Kevin K Brown; Wim Wuyts; Nadia Verbruggen; Simone Stutvoet; Ann Fieuw; Paul Ford; Walid Abi-Saab; Marlies Wijsenbeek Journal: BMJ Open Respir Res Date: 2019-05-21
Authors: Peter P LaCamera; Susan L Limb; Tmirah Haselkorn; Elizabeth A Morgenthien; John L Stauffer; Mark L Wencel Journal: Chron Respir Dis Date: 2019 Jan-Dec Impact factor: 2.444
Authors: Toby M Maher; Lisa H Lancaster; Stéphane Jouneau; Lake Morrison; David J Lederer; Maria Molina-Molina; Elisabeth Bendstrup; Klaus-Uwe Kirchgaessler; Frank Gilberg; Judit Axmann; Ute Petzinger; Paul W Noble Journal: Ann Am Thorac Soc Date: 2019-07
Authors: Colin H Holtze; Elizabeth A Freiheit; Susan L Limb; John L Stauffer; Karina Raimundo; Wayne T Pan; Kevin R Flaherty; Hyun J Kim Journal: Respir Res Date: 2020-02-10