Silva Mariana, Fernandes Amélia, Pereira Ana Rita, Madanelo Sofia, Clemêncio Tatiana, Ferreira Pedro Gonçalo
Unidade de Cuidados de Saúde Personalizados Anadia II, Anadia.
Unidade de Saúde Familiar Vale do Cértima, Oliveira do Bairro.
Multidiscip Respir Med. 2022 Apr 26;17(1):848. doi: 10.4081/mrm.2022.848. eCollection 2022 Jan 12.
Interstitial lung diseases (ILDs) comprise a group of multiple entities sharing some clinical, functional, and radiological similarities. In many countries primary care setting has been devoid of pre- and post-graduate educational interventions focused on basic knowledge on ILD. This, along with usual nonspecificity of symptoms at presentation, may contribute to diagnostic delay in this disease setting.
We designed a study questionnaire to assess the level of awareness on basic diagnostic and management aspects of core ILDs - idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, sarcoidosis, connective tissue disease related-ILD, and drug-induced ILD - among primary care physicians (GPs) from five "ACeS Baixo Vouga" health centres and to perceive possible weaknesses. Differences in awareness between GPs under 45 and over 45 yearsold were also assessed.
Globally, 69% of questions were correctly answered but only 21.9% of GPs considered to have a satisfactory self-perceived level of knowledge on ILD. Except sarcoidosis (p=0.017) and some isolated questions on other diseases, no significant differences were found between physicians below 45 years and above. Though, there was a trend to higher awareness in the younger group. The best awareness was seen in sarcoidosis. IPF questions had the worst performance and only 48.5% of GPs recognized the importance of velcro-type crackles in suggesting a possible diagnosis.
Specific attention should be devoted to educational interventions directed to GPs on basic notions on the main ILDs. This could improve the usual diagnostic delay in many ILDs, as a timely diagnosis is essential for an early treatment and prolonged patient survival.
间质性肺疾病（ILDs）是一组在临床、功能和放射学方面有一些相似之处的多种疾病。在许多国家，基层医疗环境缺乏针对ILD基础知识的研究生前和研究生教育干预措施。这一点，再加上疾病表现时症状通常缺乏特异性，可能导致这种疾病的诊断延迟。
我们设计了一项研究问卷，以评估来自五个“ACeS Baixo Vouga”健康中心的基层医疗医生（全科医生）对核心ILDs——特发性肺纤维化（IPF）、过敏性肺炎、结节病、结缔组织病相关ILD和药物性ILD——的基本诊断和管理方面的认知水平，并找出可能存在的薄弱环节。我们还评估了45岁以下和45岁以上全科医生在认知方面的差异。
总体而言，69%的问题回答正确，但只有21.9%的全科医生认为自己对ILD的认知水平令人满意。除结节病（p = 0.017）和关于其他疾病的一些个别问题外，45岁以下和45岁以上的医生之间没有发现显著差异。不过，年轻组的认知水平有更高的趋势。对结节病的认知最好。IPF相关问题的表现最差，只有48.5%的全科医生认识到捻发音在提示可能诊断方面的重要性。
应特别关注针对全科医生的关于主要ILDs基本概念的教育干预措施。这可以改善许多ILDs常见的诊断延迟情况，因为及时诊断对于早期治疗和延长患者生存期至关重要。
