DoxaPharma S.r.l., Milano, Italy.
Chron Respir Dis. 2011;8(4):225-31. doi: 10.1177/1479972311416382. Epub 2011 Aug 19.
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal lung disease of unknown origin. Despite recent advancements, the diagnosis and management of IPF remains a distinct clinical challenge; as a result, patients often experience considerable delays in receiving an accurate diagnosis and confusion regarding prognosis and the availability of treatment options. In order to gain further insights regarding patients' perspectives on the diagnostic process, disease education, emotional well-being, and quality of life, we conducted a qualitative in-depth survey among IPF patients in Europe. Patients with a physician-confirmed IPF diagnosis were recruited to participate in an in-depth interview conducted by a trained facilitator who used a qualitative topic guide. A total of 45 patients from 5 European countries participated in the survey. The median reported time from initial presentation to confirmed diagnosis of IPF was 1.5 years (range <1 week to 12 years); in 58% of cases there was a delay of >1 year between initial presentation and a confirmed diagnosis of IPF. Additionally, 55% of patients reported consulting ≥3 physicians before receiving an IPF diagnosis. Patient satisfaction with medical care and disease education appeared to be higher among patients who were receiving care at a recognized center of excellence. Patients generally had reasonable expectations regarding the goals of therapy, with most recognizing the irreversibility of the disease and the limited prospects for achieving a cure. The most common unmet needs cited by participants were disease education resources, access to centers of excellence, and familial support programs. Our findings suggest that patients with IPF commonly experience protracted delays in receiving an accurate diagnosis and generally perceive the level of medical care as suboptimal, despite expressing reasonable expectations regarding the goals of therapy. These results support the need for further improvement in the areas of diagnosis, disease management, and patient education.
特发性肺纤维化(IPF)是一种病因不明的慢性、进行性、致命性肺部疾病。尽管最近取得了进展,但 IPF 的诊断和管理仍然是一个明显的临床挑战;因此,患者通常在获得准确诊断方面存在相当大的延迟,并对预后和治疗选择的可用性感到困惑。为了更深入地了解患者对诊断过程、疾病教育、心理健康和生活质量的看法,我们在欧洲的 IPF 患者中进行了一项定性深入调查。招募了经医生确认的 IPF 诊断的患者,让他们接受经过培训的主持人进行深入访谈,主持人使用定性主题指南。来自 5 个欧洲国家的 45 名患者参加了调查。报告的从初次就诊到确诊 IPF 的中位数时间为 1.5 年(范围<1 周至 12 年);在 58%的病例中,从初次就诊到确诊 IPF 之间存在>1 年的延迟。此外,55%的患者报告在获得 IPF 诊断之前咨询了≥3 名医生。在卓越中心接受治疗的患者对医疗护理和疾病教育的满意度似乎更高。患者对治疗目标的期望似乎较为合理,大多数人认识到疾病的不可逆转性和治愈的有限前景。参与者提到的最常见的未满足需求是疾病教育资源、获得卓越中心的机会和家庭支持计划。我们的研究结果表明,IPF 患者通常会经历漫长的时间才能获得准确的诊断,并且普遍认为医疗护理水平不理想,尽管他们对治疗目标的期望较为合理。这些结果支持需要进一步改进诊断、疾病管理和患者教育领域。