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The diagnostic pathway for patients with interstitial lung disease: a mixed-methods study of patients and physicians.
Grant-Orser, Amanda; Pooler, Charlotte; Archibald, Nathan; Fell, Charlene; Ferrara, Giovanni; Johannson, Kerri A; Kalluri, Meena.
Afiliación
  • Grant-Orser A; Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada amanda.grant-orser@mail.mcgill.ca.
  • Pooler C; Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
  • Archibald N; Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
  • Fell C; Palliative and End of Life Program, Alberta Health Services, Edmonton, Alberta, Canada.
  • Ferrara G; Department of Medicine, Division of Respirology, University of Alberta, Edmonton, Alberta, Canada.
  • Johannson KA; Department of Medicine, Division of Respirology, University of Calgary, Calgary, Alberta, Canada.
  • Kalluri M; Department of Medicine, Division of Respirology, University of Alberta, Edmonton, Alberta, Canada.
BMJ Open Respir Res ; 11(1)2024 Apr 30.
Article en En | MEDLINE | ID: mdl-38688689
ABSTRACT

OBJECTIVES:

The diagnostic process for patients with interstitial lung diseases (ILD) remains complex. The aim of this study was to characterise the diagnostic care pathway and identify barriers and potential solutions to access a timely and accurate ILD diagnosis.

DESIGN:

This mixed-method study was comprised of a quantitative chart review, patient and physician surveys and focus groups.

RESULTS:

Chart review was completed for 97 patients. Median time from symptom onset to ILD diagnosis was 12.0 (IQR 20.5) months, with 46% diagnosed within 1 year. Time from first computed tomography (CT) scan to respirology referral was 2.4 (IQR 21.2) months. Referrals with a prior CT were triaged sooner than referrals without (1.7±1.6 months vs 3.9±3.3 months, p=0.013, 95% CI 0.48 to 2.94). On patient surveys (n=70), 51% felt that their lung disease was not recognised early enough. Commonly reported challenges to timely diagnosis included delayed presentation to primary care, initial misdiagnoses and long wait-times for specialists. Forty-five per cent of physicians (n=20) identified diagnostic delays, attributed to delayed presentations to primary care (58%), initial misdiagnoses (67%) and delayed chest imaging (75%). Themes from patient and respirologist focus groups included patient-related, healthcare provider-related and system-related factors leading to delays in diagnosis.

CONCLUSIONS:

This mixed-methods study identified patient and system-related factors that contribute to diagnostic delays for patients with ILD, with most delays occurring prior to respirology referral. ILD awareness and education, earlier presentation to primary care, expedited access to chest imaging and earlier referral to respirology may expedite diagnosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Tomografía Computarizada por Rayos X / Enfermedades Pulmonares Intersticiales Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMJ Open Respir Res Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Derivación y Consulta / Tomografía Computarizada por Rayos X / Enfermedades Pulmonares Intersticiales Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: BMJ Open Respir Res Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido