Hollmen Maria, Bromilow Tom, Smith Adam B, Mealing Stuart, Lewis Damian, Galvin Liam, Jones Steve, Pacheco Luís, Soulard Stéphane, Froidure Antoine
Faculty of Medicine, University of Helsinki, Helsinki, Finland.
York Health Economics Consortium (YHEC), York, UK.
Patient Prefer Adherence. 2023 Aug 4;17:1621-1639. doi: 10.2147/PPA.S408857. eCollection 2023.
Idiopathic Pulmonary Fibrosis (IPF) is a rare disease that causes shortness of breath, dry cough, and tiredness. While there is no cure for IPF, current therapeutic treatments aim to slow lung degeneration while managing side effects. There is little known about patient experience and attitude with regards to their disease and medication.
To understand the perceptions, behaviors and drivers of treatment decision-making among patients, caregivers and pulmonologists in IPF.
Online surveys to patients with IPF, caregivers and pulmonologists were developed and administered in Belgium, Finland, France, Greece (pulmonologists only), the Netherlands, Ireland and the United Kingdom between November 2021 and January 2022.
A total of 111 patients, 22 caregivers and 140 pulmonologists participated. Half (47%) of patients rated their disease as "severe", while pulmonologists reported that a quarter of their patients had a low Forced Vital Capacity (FVC) (below 50% of the predicted value). Between 21% and 42% of the patients do not take an IPF medication (patients' perception) or antifibrotic (physicians' perception). Pulmonologists reported that a total of 58% of their patients were receiving antifibrotic medication, any IPF medication, while around 53%, 55%, 35% and 73% of the patients limited their exposure (sometimes or often) to the sun due to IPF, considered taking medication against diarrhea, nausea/vomiting and heartburn, respectively. Treatment adherence was relatively high (81%), in line with the caregivers' view and the pulmonologists' expectations. Overall, cultural, clinical or socio-demographic factors impacted patients' perceptions or behaviors.
This study shows there is a significant proportion of IPF patients who remain untreated, a misalignment of disease severity between patients and their physicians and patient background impacts behavior. Overall, more in-depth patient-physician communication is needed to improve treatment experience.
特发性肺纤维化(IPF)是一种罕见疾病,会导致呼吸急促、干咳和疲劳。虽然IPF无法治愈,但目前的治疗方法旨在减缓肺部退化并控制副作用。关于患者对其疾病和药物治疗的体验及态度,人们了解甚少。
了解IPF患者、护理人员和肺科医生在治疗决策方面的认知、行为和驱动因素。
2021年11月至2022年1月期间,在比利时、芬兰、法国、希腊(仅肺科医生)、荷兰、爱尔兰和英国开展并实施了针对IPF患者、护理人员和肺科医生的在线调查。
共有111名患者、22名护理人员和140名肺科医生参与。一半(47%)的患者将其疾病评为“严重”,而肺科医生报告称,四分之一 的患者用力肺活量(FVC)较低(低于预测值的50%)。21%至42%的患者未服用IPF药物(患者认知)或抗纤维化药物(医生认知)。肺科医生报告称,共有58%的患者正在接受抗纤维化药物治疗,即任何IPF药物,而分别约有53%、55%、35%和73%的患者因IPF限制(有时或经常)晒太阳、考虑服用抗腹泻、抗恶心/呕吐和抗烧心的药物。治疗依从性相对较高(81%),与护理人员的看法和肺科医生的期望一致。总体而言,文化、临床或社会人口统计学因素会影响患者的认知或行为。
本研究表明,有相当比例的IPF患者未得到治疗,患者与其医生对疾病严重程度的认知存在偏差,且患者背景会影响行为。总体而言,需要更深入的医患沟通来改善治疗体验。