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COVID-19 大流行对特发性肺纤维化患者随访和治疗的影响:一项横断面、多中心电话调查。

Effects of the COVID-19 pandemic on the follow-up and treatment of patients with idiopathic pulmonary fibrosis: a cross-sectional, multicentre phone call survey.

机构信息

Department of Chest Diseases, Bursa Uludag University, Bursa, Turkey

Department of Chest Diseases, Cukurova University Faculty of Medicine, Adana, Turkey.

出版信息

BMJ Open. 2021 Aug 12;11(8):e050578. doi: 10.1136/bmjopen-2021-050578.

Abstract

OBJECTIVE

To learn about the attitudes and behaviours of patients with idiopathic pulmonary fibrosis (IPF) in relation to the difficulties experienced during the COVID-19 pandemic.

DESIGN

A cross-sectional, multicentre phone call survey.

SETTING

Four university hospitals in Turkey.

PARTICIPANTS

The study included patients with IPF receiving antifibrotics for at least 3 months and with doctor appointment and/or scheduled routine blood analysis between March and May 2020 (the first 3 months after the official announcement of the COVID-19 pandemic in Turkey).

INTERVENTIONS

Phone calls (a 5 min interview) were performed in June 2020. A questionnaire and the Hospital Anxiety-Depression Scale were applied.

MAIN OUTCOME MEASURES

Patients' preferences for disease monitoring, patients' attitudes and behaviours towards IPF, drug continuation, COVID-19 diagnosis and anxiety/depression status.

RESULTS

The study included 115 patients with IPF (82 male; mean age, 68.43±7.44 years). Of the patients, 73.9% had doctor appointment and 52.2% had scheduled routine blood testing; 54.5% of patients with doctor appointment self-cancelled their appointments and 53.3% of patients with scheduled routine blood testing did not undergo testing. Of the patients, 32.2% were on nintedanib and 67.8% were on pirfenidone; self-initiated drug discontinuation rate was 22.6%. The percentage of patients communicating with their physicians was 35.7%. The route of communication was by phone (34.8%). The frequency of depression and anxiety was 27.0% and 38.3%, respectively. The rates of drug discontinuation (35.1% vs 16.7%, p<0.05) and depression (37.8% vs 21.8%, p=0.07) were higher in nintedanib users than in pirfenidone users. Only two (1.7%) patients had COVID-19 diagnosis.

CONCLUSIONS

During the COVID-19 pandemic, a significant proportion (>50%) of patients self-cancelled their appointments and nearly a quarter of patients discontinued their medications. Providing a documentation of the problems experienced by patients with IPF about management of the necessary requirements during the COVID-19 pandemic, this study may be a model for patients with chronic diseases.

摘要

目的

了解特发性肺纤维化(IPF)患者在 COVID-19 大流行期间所经历困难方面的态度和行为。

设计

横断面、多中心电话调查。

地点

土耳其的四所大学医院。

参与者

本研究纳入了至少接受抗纤维化治疗 3 个月且在 2020 年 3 月至 5 月(土耳其宣布 COVID-19 大流行后的头 3 个月)期间有医生预约和/或预定常规血液分析的 IPF 患者。

干预措施

2020 年 6 月进行电话访谈(5 分钟访谈)。应用问卷和医院焦虑抑郁量表。

主要结局测量指标

患者对疾病监测的偏好、患者对 IPF 的态度和行为、药物续用、COVID-19 诊断和焦虑/抑郁状况。

结果

本研究纳入了 115 例 IPF 患者(82 例男性;平均年龄 68.43±7.44 岁)。其中 73.9%有医生预约,52.2%有预定的常规血液检查;54.5%有医生预约的患者自行取消预约,53.3%有预定常规血液检查的患者未进行检查。其中 32.2%患者服用尼达尼布,67.8%患者服用吡非尼酮;自行停药率为 22.6%。与医生沟通的患者比例为 35.7%。沟通途径为电话(34.8%)。抑郁和焦虑的发生率分别为 27.0%和 38.3%。尼达尼布组停药率(35.1% vs. 16.7%,p<0.05)和抑郁发生率(37.8% vs. 21.8%,p=0.07)均高于吡非尼酮组。仅 2 例(1.7%)患者被诊断为 COVID-19。

结论

在 COVID-19 大流行期间,超过一半(>50%)的患者自行取消预约,近四分之一的患者停止用药。本研究为 IPF 患者提供了在 COVID-19 大流行期间管理必要需求方面所遇到问题的记录,可为慢性病患者提供借鉴。

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Impact of Depression on Patients With Idiopathic Pulmonary Fibrosis.抑郁症对特发性肺纤维化患者的影响。
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Prognosis and Follow-Up of Idiopathic Pulmonary Fibrosis.特发性肺纤维化的预后与随访
Med Sci (Basel). 2018 Jun 14;6(2):51. doi: 10.3390/medsci6020051.

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