Abstract：
BACKGROUND:For patients with idiopathic pulmonary fibrosis (IPF), there is limited real-world data on patient journey and treatment patterns. AIM:To explore predictors of early diagnosis and treatment initiation, and treatment patterns in IPF patients using linked data from Swedish registers and electronic medical records (EMRs). POPULATION:A national cohort (C1) of 17,247 pulmonary fibrosis patients (ICD-10 code J84.1; no competing diagnosis) diagnosed between 2001 and 2015, and an EMR-based regional subset (C2) comprising 1755 IPF patients diagnosed between 2004 and 2017. The time from early disease symptoms to diagnosis, use of anti-fibrotic medications, time from diagnosis to initiation of anti-fibrotic treatment, and adherence, persistence and treatment length with pirfenidone were explored in these patients. RESULTS:In C1, the median time to diagnosis from the first symptoms dyspnoea, cough and fatigue were 307, 563 and 639 days, respectively. Glucocorticoids were the most frequently prescribed medication. Less than 10% of patients undergoing or initiating treatment, used pirfenidone or nintedanib. Males had a higher probability of initiating anti-fibrotic treatment than females within a year of diagnosis. One-year persistence in pirfenidone patients was 42% in C1 and 25% in C2. CONCLUSION:Diagnosis of pulmonary fibrosis was delayed in patients with cough and fatigue, which are early symptoms of IPF. This, and lower than expected utilisation of anti-fibrotic medications, suggests missed opportunities for early disease diagnosis and treatment. The high rate of treatment discontinuation underscores the importance of supporting and guiding patients to persist with their medications to ensure an accrual benefit of treatment.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Sköld CM,Arnheim-Dahlström L,Bartley K,Janson C,Kirchgaessler KU,Levine A,Ferrara Gdoi
10.1016/j.rmed.2019.06.001subject
Has Abstractpub_date
2019-08-01 00:00:00pages
72-78eissn
0954-6111issn
1532-3064pii
S0954-6111(19)30182-9journal_volume
155pub_type
杂志文章abstract：:Aminophylline administration was compared in 43 patients who died from asthma and 43 matched controls who were admitted, suffering from acute asthma, to hospitals in the North East Thames Region. A computer program, which used information about individual characteristics, medical history and drug intake, was employed ...
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journal_title：Respiratory medicine
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journal_title：Respiratory medicine
pub_type： 杂志文章
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journal_title：Respiratory medicine
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journal_title：Respiratory medicine
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更新日期：2002-02-01 00:00:00
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pub_type： 杂志文章,多中心研究
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journal_title：Respiratory medicine
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pub_type： 杂志文章
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更新日期：1993-02-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章
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更新日期：1994-11-01 00:00:00
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更新日期：2017-05-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章
doi：10.1016/j.rmed.2008.08.012
更新日期：2008-12-01 00:00:00
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journal_title：Respiratory medicine
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doi：10.1016/s0954-6111(97)90093-7
更新日期：1997-10-01 00:00:00
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pub_type： 杂志文章,评审
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更新日期：1991-01-01 00:00:00
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pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Respiratory medicine
pub_type： 杂志文章,随机对照试验
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journal_title：Respiratory medicine
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更新日期：2007-05-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章
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更新日期：2010-04-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2001-05-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章,多中心研究
doi：10.1016/j.rmed.2017.11.018
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Interleukin-32(IL-32)γ is a pro-inflammatory cytokine involved in the development and severity of chronic inflammatory diseases, but its role in asthma is unclear. OBJECTIVE:This study was conducted to evaluate the relationship of IL-32γ levels in sputum with the severity of asthma. METHODS:IL-32γ levels i...
journal_title：Respiratory medicine
pub_type： 杂志文章
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更新日期：2017-08-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章
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更新日期：2000-08-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章
doi：10.1016/j.rmed.2005.11.008
更新日期：2007-02-01 00:00:00
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journal_title：Respiratory medicine
pub_type： 杂志文章
doi：10.1016/j.rmed.2006.08.024
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Tracheal collapse is a weakness of the tracheal wall leading to expiratory central airway collapse of more than 50% compared to inspiration. It has previously been discussed whether the collapsibility of the greater airways is a stable or a dynamic condition. Indeed, other well-known lung diseases such as as...
journal_title：Respiratory medicine
pub_type： 杂志文章
doi：10.1016/j.rmed.2018.11.018
更新日期：2019-01-01 00:00:00
