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), the Respiratory Effectiveness Group’s Interstitial Lung Disease Working group

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

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 languageEnglish
Number of pages9
JournalRespirology
Early online date11 May 2020
DOIs
Publication statusE-pub ahead of print - 11 May 2020

Keywords

  • clinical epidemiology
  • clinical respiratory medicine
  • cough
  • pulmonary fibrosis
  • respiratory function tests
  • IDIOPATHIC PULMONARY-FIBROSIS

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    Jones, M. G., Hillyar, C. R. T., Nibber, A., Chisholm, A., Wilson, A., Maher, T. M., Kaplan, A., Price, D., Walsh, S., Richeldi, L., & the 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. https://doi.org/10.1111/resp.13836