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Expectations about treatment of idiopathic pulmonary fibrosis: Comparative survey of patients, carers and physicians (the RESPIR French survey) - 11/06/21

Doi : 10.1016/j.resmer.2020.100811 
V. Cottin a, 1, , E. Bergot b, A. Bourdin c, H. Nunes d, G. Prévot e, B. Wallaert f, S. Marchand-Adam g
a National reference coordinating center for rare lung diseases, pulmonology department, Louis-Pradel hospital, hospices civils de Lyon, UMR754, université de Lyon, université Claude-Bernard Lyon 1, INREA, member of OrphaLung, RespiFil, Radico-ILD, and ERN-LUNG, Lyon, France 
b Pulmonology department, University-affiliated hospital of Caen, Caen, France 
c Pulmonology and addictology department, University-affiliated hospital of Montpellier, Montpellier, France 
d Pulmonology department, AP–HP, Avicenne University Hospital, Bobigny, France 
e Pulmonology department, Hospital of Toulouse, Toulouse, France 
f Pulmonology and Allergy/immunology department, Regional University-affiliated hospital of Lille, Lille, France 
g Pulmonology department, Regional University-affiliated hospital of Tours, Tours, France 

Corresponding author at: Centre national de référence coordonnateur des maladies pulmonaires rares, groupement hospitalier Est, bâtiment A4, pneumologie, 28, avenue Doyen-Lépine, 69677 Lyon cedex, France.Centre national de référence coordonnateur des maladies pulmonaires rares, groupement hospitalier Estbâtiment A4, pneumologie, 28, avenue Doyen-LépineLyon cedex69677France

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Abstract

Context

Idiopathic pulmonary fibrosis (IPF) is a severe chronic disease during which anxiety and depression are frequent comorbidities. Better knowledge of patients’ expectations is needed to inform an action plan to improve medical care.

Aim

To describe feelings and expectations of patients suffering from IPF and of their carers about antifibrotic therapy and compare them to what is perceived by their pulmonologist.

Methods

National prospective study on practices and perceptions. Specific questionnaires were e-mailed to all 3276 pulmonologists in France who, in turn, invited patients and carers to participate in a survey.

Results

147 pulmonologists, 161 patients and 144 carers participated in the survey. The role of the carer was evaluated as “important” or “very important” by more than 90% of participants, i.e. pulmonologists, patients or carers. Inconsistencies between how patients felt and how pulmonologists perceived them were identified: 88% of patients responded that they understood quite well what IPF is (vs. 75% of patients according to pulmonologists); 85.5% of patients said they were determined to fight the disease (vs. 68.0%); 61.7% of patients wanted to be kept informed of potential complications before they occurred (vs. 69.6%) and 81.2% wanted to be involved in therapeutic decisions (vs. 43.1%). Globally, patients had a more positive view of antifibrotic therapies than expected by pulmonologists: 41.5% evaluated their advantages superior to what they had expected (vs. 29.1% of patients according to pulmonologists) and 76.5% had a positive image of the benefits/disadvantages ratio (vs. 62.4%). Although pulmonologists had the impression that they were keeping their patients well-informed about exacerbations, hospital stays and the possible negative evolution of the disease despite antifibrotic therapies, 34.0%, 42.0% and 22.0% of patients respectively declared not being aware of these aspects.

Conclusion

The feelings of patients suffering from IPF regarding their disease and treatment globally proved more positive compared with how pulmonologists perceived them. Taking into account the expectations and needs of patients may allow healthcare professionals to better address their needs and priorities.

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Keywords : Idiopathic pulmonary fibrosis, Patient and carer experience, Survey, Management, Drug therapy


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