Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care: A Primary Care Cohort Study

Mark G. Jones; Christopher R.T. Hillyar; Anjan Nibber; Alison Chisholm; Andrew Wilson; Toby M. Maher; Alan Kaplan; David Price; Simon Walsh; Luca Richeldi; Respiratory Effectiveness Group’s Interstitial Lung Disease Working group

doi:10.1111/resp.13836

Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care: A Primary Care Cohort Study

Mark G. Jones, Christopher R.T. Hillyar, Anjan Nibber, Alison Chisholm, Andrew Wilson, Toby M. Maher, Alan Kaplan, David Price, Simon Walsh, Luca Richeldi^* (Corresponding Author), Respiratory Effectiveness Group’s Interstitial Lung Disease Working group

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background and objective
Temporal trends of healthcare use in the period before a diagnosis of pulmonary fibrosis are poorly understood. We investigated trends in respiratory symptoms and LR HRU in the 10 years prior to diagnosis.

Methods
We analysed a primary care clinical cohort database (UK OPCRD) and assessed patients aged ≥40 years who had an electronically coded diagnosis of pulmonary fibrosis between 2005 and 2015 and a minimum 2 years of continuous medical records prior to diagnosis. Exclusion criteria consisted of electronic codes for recognized causes of pulmonary fibrosis such as CTD, sarcoidosis or EAA.

Results
Data for 2223 patients were assessed. Over the 10 years prior to diagnosis of pulmonary fibrosis, there was a progressive increase in HRU across multiple LR‐related domains. Five years before diagnosis, 18% of patients had multiple healthcare contacts for LR complaints; this increased to 79% in the year before diagnosis, with 38% of patients having five or more healthcare contacts.

Conclusion
There are opportunities to diagnose pulmonary fibrosis at an earlier stage; research into case‐finding algorithms and strategies to educate primary care physicians is required.

Original language	English
Pages (from-to)	1274-1282
Number of pages	9
Journal	Respirology
Volume	25
Issue number	12
Early online date	11 May 2020
DOIs	https://doi.org/10.1111/resp.13836
Publication status	Published - 1 Dec 2020

Keywords

clinical epidemiology
clinical respiratory medicine
cough
pulmonary fibrosis
respiratory function tests

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This is the peer reviewed version of the following article: [jones, MG, Hillyar, CRT, Nibber, A, et al. Opportunities to diagnose fibrotic lung diseases in routine care: A primary care cohort study. Respirology. 2020; 25: 1274– 1282.], which has been published in final form at https://doi.org/10.1111/resp.13836. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Accepted author manuscript, 1.24 MBLicence: Unspecified

Cite this

Jones, M. G., Hillyar, C. R. T., Nibber, A., Chisholm, A., Wilson, A., Maher, T. M., Kaplan, A., Price, D., Walsh, S., Richeldi, L., & Respiratory Effectiveness Group’s Interstitial Lung Disease Working group (2020). Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care: A Primary Care Cohort Study. Respirology, 25(12), 1274-1282. https://doi.org/10.1111/resp.13836

Jones, MG, Hillyar, CRT, Nibber, A, Chisholm, A, Wilson, A, Maher, TM, Kaplan, A, Price, D, Walsh, S, Richeldi, L & Respiratory Effectiveness Group’s Interstitial Lung Disease Working group 2020, 'Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care: A Primary Care Cohort Study', Respirology, vol. 25, no. 12, pp. 1274-1282. https://doi.org/10.1111/resp.13836

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title = "Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care: A Primary Care Cohort Study",

abstract = "Background and objectiveTemporal trends of healthcare use in the period before a diagnosis of pulmonary fibrosis are poorly understood. We investigated trends in respiratory symptoms and LR HRU in the 10 years prior to diagnosis.MethodsWe analysed a primary care clinical cohort database (UK OPCRD) and assessed patients aged ≥40 years who had an electronically coded diagnosis of pulmonary fibrosis between 2005 and 2015 and a minimum 2 years of continuous medical records prior to diagnosis. Exclusion criteria consisted of electronic codes for recognized causes of pulmonary fibrosis such as CTD, sarcoidosis or EAA.ResultsData for 2223 patients were assessed. Over the 10 years prior to diagnosis of pulmonary fibrosis, there was a progressive increase in HRU across multiple LR‐related domains. Five years before diagnosis, 18% of patients had multiple healthcare contacts for LR complaints; this increased to 79% in the year before diagnosis, with 38% of patients having five or more healthcare contacts.ConclusionThere are opportunities to diagnose pulmonary fibrosis at an earlier stage; research into case‐finding algorithms and strategies to educate primary care physicians is required.",

keywords = "clinical epidemiology, clinical respiratory medicine, cough, pulmonary fibrosis, respiratory function tests",

author = "Jones, {Mark G.} and Hillyar, {Christopher R.T.} and Anjan Nibber and Alison Chisholm and Andrew Wilson and Maher, {Toby M.} and Alan Kaplan and David Price and Simon Walsh and Luca Richeldi and {Respiratory Effectiveness Group{\textquoteright}s Interstitial Lung Disease Working group}",

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doi = "10.1111/resp.13836",

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T1 - Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care

T2 - A Primary Care Cohort Study

AU - Jones, Mark G.

AU - Hillyar, Christopher R.T.

AU - Nibber, Anjan

AU - Chisholm, Alison

AU - Wilson, Andrew

AU - Maher, Toby M.

AU - Kaplan, Alan

AU - Price, David

AU - Walsh, Simon

AU - Richeldi, Luca

AU - Respiratory Effectiveness Group’s Interstitial Lung Disease Working group

PY - 2020/12/1

Y1 - 2020/12/1

N2 - Background and objectiveTemporal trends of healthcare use in the period before a diagnosis of pulmonary fibrosis are poorly understood. We investigated trends in respiratory symptoms and LR HRU in the 10 years prior to diagnosis.MethodsWe analysed a primary care clinical cohort database (UK OPCRD) and assessed patients aged ≥40 years who had an electronically coded diagnosis of pulmonary fibrosis between 2005 and 2015 and a minimum 2 years of continuous medical records prior to diagnosis. Exclusion criteria consisted of electronic codes for recognized causes of pulmonary fibrosis such as CTD, sarcoidosis or EAA.ResultsData for 2223 patients were assessed. Over the 10 years prior to diagnosis of pulmonary fibrosis, there was a progressive increase in HRU across multiple LR‐related domains. Five years before diagnosis, 18% of patients had multiple healthcare contacts for LR complaints; this increased to 79% in the year before diagnosis, with 38% of patients having five or more healthcare contacts.ConclusionThere are opportunities to diagnose pulmonary fibrosis at an earlier stage; research into case‐finding algorithms and strategies to educate primary care physicians is required.

AB - Background and objectiveTemporal trends of healthcare use in the period before a diagnosis of pulmonary fibrosis are poorly understood. We investigated trends in respiratory symptoms and LR HRU in the 10 years prior to diagnosis.MethodsWe analysed a primary care clinical cohort database (UK OPCRD) and assessed patients aged ≥40 years who had an electronically coded diagnosis of pulmonary fibrosis between 2005 and 2015 and a minimum 2 years of continuous medical records prior to diagnosis. Exclusion criteria consisted of electronic codes for recognized causes of pulmonary fibrosis such as CTD, sarcoidosis or EAA.ResultsData for 2223 patients were assessed. Over the 10 years prior to diagnosis of pulmonary fibrosis, there was a progressive increase in HRU across multiple LR‐related domains. Five years before diagnosis, 18% of patients had multiple healthcare contacts for LR complaints; this increased to 79% in the year before diagnosis, with 38% of patients having five or more healthcare contacts.ConclusionThere are opportunities to diagnose pulmonary fibrosis at an earlier stage; research into case‐finding algorithms and strategies to educate primary care physicians is required.

KW - clinical epidemiology

KW - clinical respiratory medicine

KW - cough

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KW - respiratory function tests

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DO - 10.1111/resp.13836

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SN - 1323-7799

VL - 25

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EP - 1282

JO - Respirology

JF - Respirology

IS - 12

ER -

Opportunities to Diagnose Fibrotic Lung Diseases in Routine Care: A Primary Care Cohort Study

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