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Ahmed L, Bergot E, Prévot G, Cottin V. Ethnographic survey of patients and caregiver's life journey in idiopathic pulmonary fibrosis. Respir Med Res 2022; 83:100955. [PMID: 36634553 DOI: 10.1016/j.resmer.2022.100955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/30/2022] [Accepted: 09/19/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease associated with high mortality. The IPF journey affects patients' and caregivers' quality of life, this should be taken into account as an important parameter for a better disease management. An ethnographic study was conducted between December 2019 and January 2020 to explore social disease representations, patients' and cargivers' experiences in the disease journey and consequences in their daily life, to identify the means of actions permitting a quality of life (QoL) improvement. PATIENTS/CAREGIVERS Twenty respondents, twelve patients aged 43 to 84 years old and eight caregivers in four French regions were met. Eleven patients were diagnosed with IPF between 2013 and 2017 and one patient in 1988 (at 12 years old). The lung function reported by patients ranged as follows: forced vital capacity from 112% to 40% and diffusing capacity of the lungs for carbon monoxide (DLCO) from 66% to <20%. RESULTS The survey included patients diagnosed at least three years ago. Collected data comprised disease representation, patients'/caregivers' experience of the disease, healthcare journey, and consequences for their daily life. The first signs identified by the patient or their caregiver may not have been taken seriously by the primary care physician. The pre-diagnosis period was considered particularly traumatic for most patients. The biopsy performed in 8 cases was experienced as violent by 4/8 patients, some of whom still feel pain. Patients/caregivers knew how to define their disease and spontaneously gave severe representations of the disease such as "Rare, incurable disease", "an organ being destroyed". DISCUSSION This study highlighted patients'/caregivers' common needs at each stage of the disease. The lack of disease knowledge from frontline practitioners (general physicians, community pulmonologists) can lead to significant diagnostic error. Patients require psychological support and more information on daily aspects in disease management, such as food good practices and importance of physical activity, along with information about disease progression. The fear caused by these shortages can be reduced through contact with patients' associations. CONCLUSIONS Numerous essential data were identified and should be considered for supporting actions that could allow to improve the QoL of patients with IPF.
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Affiliation(s)
| | | | | | - Vincent Cottin
- HCL UCBL - GH Est-Hôpital Louis Pradel, 69677 BRON, France.
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Percepción de los pacientes en cuanto al manejo de la fibrosis pulmonar idiopática. Proyecto Explora-IPF. OPEN RESPIRATORY ARCHIVES 2022. [PMID: 37497178 PMCID: PMC10369542 DOI: 10.1016/j.opresp.2022.100158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction Idiopathic pulmonary fibrosis (IPF) impacts the life of patients and their families, so it is necessary to ascertain their perception in the approach to their disease. Methods Observational study by means of a specific questionnaire that includes socio-demographic and clinical variables, perception of the impact of the disease (5-point Likert scale), preferences regarding the characteristics of the medication (degree of importance/concern 1-10) and satisfaction with treatment (SATMED-Q® scale 0-100). Results 69 individuals participated (age: 66.5 ± 7.6 years; time until diagnosis: 16.5 ± 17.4 months; diagnosis time: 49.6 ± 42.3 months). The majority state that IPF limits them physically (90%) and emotionally (75%). The most highly valued features of the treatment were: slowing down progression of the disease (7.4 ± 2.8), stabilising lung capacity (6.9 ± 2.8) and improving quality of life (6.9 ± 2.8), above stabilising/improving symptoms (6.1 ± 2.8/6.3 ± 2.8) or avoiding hospitalisation (6.6 ± 2.7). The principal factors of concern were suffering gastric disorders (7.1 ± 2.9), photosensitivity (6.6 ± 3.0) or interaction with other drugs (6.0 ± 3.0). Overall satisfaction with the current treatment scored 61.1 points, with the highest scores being for medical follow-up (79.5) and overall opinion of the medicine (74.3). Conclusions A study conducted in Spain on the perspective of IPF patients regarding the disease and its treatment. The results show a high level of awareness in terms of the seriousness of the disease on the part of patients, whose main concern is to slow down its progression. The information provided may help to optimise the management of IPF patients.
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Aronson KI, Danoff SK, Russell AM, Ryerson CJ, Suzuki A, Wijsenbeek MS, Bajwah S, Bianchi P, Corte TJ, Lee JS, Lindell KO, Maher TM, Martinez FJ, Meek PM, Raghu G, Rouland G, Rudell R, Safford MM, Sheth JS, Swigris JJ. Patient-centered Outcomes Research in Interstitial Lung Disease: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2021; 204:e3-e23. [PMID: 34283696 PMCID: PMC8650796 DOI: 10.1164/rccm.202105-1193st] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: In the past two decades, many advances have been made to our understanding of interstitial lung disease (ILD) and the way we approach its treatment. Despite this, many questions remain unanswered, particularly those related to how the disease and its therapies impact outcomes that are most important to patients. There is currently a lack of guidance on how to best define and incorporate these patient-centered outcomes in ILD research. Objectives: To summarize the current state of patient-centered outcomes research in ILD, identify gaps in knowledge and research, and highlight opportunities and methods for future patient-centered research agendas in ILD. Methods: An international interdisciplinary group of experts was assembled. The group identified top patient-centered outcomes in ILD, reviewed available literature for each outcome, highlighted important discoveries and knowledge gaps, and formulated research recommendations. Results: The committee identified seven themes around patient-centered outcomes as the focus of the statement. After a review of the literature and expert committee discussion, we developed 28 research recommendations. Conclusions: Patient-centered outcomes are key to ascertaining whether and how ILD and interventions used to treat it affect the way patients feel and function in their daily lives. Ample opportunities exist to conduct additional work dedicated to elevating and incorporating patient-centered outcomes in ILD research.
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Ramadurai D, Corder S, Churney T, Graney B, Harshman A, Meadows S, Swigris JJ. Idiopathic pulmonary fibrosis: Educational needs of health-care providers, patients, and caregivers. Chron Respir Dis 2020; 16:1479973119858961. [PMID: 31288534 PMCID: PMC6616062 DOI: 10.1177/1479973119858961] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with poor
quality of life. Debilitating symptoms and the reality of shortened survival
impact patients’ physical and emotional well-being and constrain the lives of
patients’ caregivers. This study assessed the informational needs of medical
providers who care for patients with IPF, IPF patients themselves, and their
caregivers. Tailored surveys were sent electronically to providers, patients
with IPF, and caregivers of patients with IPF collected on a rolling basis in
March of 2017. Providers answered questions regarding their own informational
needs and what information they believed patients needed. Patients and
caregivers identified their own informational needs and the perceived needs for
each other. About 2636 surveys were sent to providers, including 2041 to
physicians, of whom 156 completed it. One hundred sixty patients and 29
caregivers responded to the survey via a link on a website. Eighty-six percent
of providers described themselves as physicians who diagnose and treat IPF
patients themselves. Providers ranked information on “making the diagnosis of
IPF” as their top informational need. Patients and caregivers chose “disease
progression/what to expect” as the most important informational need for
themselves and for each other. Providers want to make a correct diagnosis when
IPF is in the differential diagnosis. Patients and caregivers desire clarity
around how IPF will behave over time and what their futures with IPF will look
like. Resources for patients and their caregivers should include information on
disease natural history in empathically worded, clear, and easily accessible
formats.
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Affiliation(s)
- Deepa Ramadurai
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Stephanie Corder
- 2 Office of Professional Education, National Jewish Health, Denver, CO, USA
| | - Tara Churney
- 3 Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - Bridget Graney
- 4 Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrea Harshman
- 2 Office of Professional Education, National Jewish Health, Denver, CO, USA
| | | | - Jeffrey J Swigris
- 3 Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
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Disease Severity and Quality of Life in Patients With Idiopathic Pulmonary Fibrosis. Chest 2020; 157:1188-1198. [DOI: 10.1016/j.chest.2019.11.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/27/2019] [Accepted: 11/30/2019] [Indexed: 11/20/2022] Open
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Hambly N, Goodwin S, Aziz-Ur-Rehman A, Makhdami N, Ainslie-Garcia M, Grima D, Cox G, Kolb M, Fung D, Cabalteja C, DeMarco P, Moldaver D. A cross-sectional evaluation of the idiopathic pulmonary fibrosis patient satisfaction and quality of life with a care coordinator. J Thorac Dis 2019; 11:5547-5556. [PMID: 32030274 DOI: 10.21037/jtd.2019.11.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Canadian and international guidelines recommend specialized, multidisciplinary teams for the treatment of patients with idiopathic pulmonary fibrosis (IPF). The objective of this cross-sectional clinical study was to investigate the effect of a care coordinator on IPF patient satisfaction and quality of life. Methods Forty IPF patients were enrolled from the practices of two physicians (n=20/physician), with either low (LCU) or high-coordinator use (HCU). Patient satisfaction was measured with modified FAMCARE and IPF Care UK Patient Support Program (UK-CARE) surveys. Health related quality of life (HRQoL) was assessed with the living with IPF impacts (L-IPFi) survey. An economic model assessed the impact of the coordinator; staff surveys informed patient management requirements, and costs were derived from published literature. Results Patient satisfaction was similar between the clinics; a trend (P=0.1) towards increased satisfaction among HCU patients was observed. Patients in the HCU clinic reported increased satisfaction (P<0.05) with their current care compared with care prior to joining the tertiary-care clinic, while LCU patients did not. IPF patient HRQoL did not differ between clinics. The coordinator was estimated to alleviate approximately 30% of a physician's IPF-related work load, and to facilitate the care of more patients per physician. Modelled estimates suggest the coordinator lead to annual cost-savings of $137,212. Conclusions Reliance upon a coordinator during routine management of IPF patients may improve patient satisfaction, spare physician time and lead to annual cost-savings. Future studies should examine the impact of a coordinator on healthcare resource utilization.
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Affiliation(s)
- Nathan Hambly
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Goodwin
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Afia Aziz-Ur-Rehman
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Nima Makhdami
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - Daniel Grima
- Cornerstone Research Group, Burlington, Ontario, Canada
| | - Gerard Cox
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Martin Kolb
- Firestone Institute for Respiratory Health, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Division of Respirology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Diana Fung
- Department of Medical Affairs, Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Czerysh Cabalteja
- Department of Medical Affairs, Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
| | - Patricia DeMarco
- Department of Medical Affairs, Hoffmann-La Roche Ltd, Mississauga, Ontario, Canada
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Witt S, Krauss E, Barbero MAN, Müller V, Bonniaud P, Vancheri C, Wells AU, Vasakova M, Pesci A, Klepetko W, Seeger W, Crestani B, Leidl R, Holle R, Schwarzkopf L, Guenther A. Psychometric properties and minimal important differences of SF-36 in Idiopathic Pulmonary Fibrosis. Respir Res 2019; 20:47. [PMID: 30823880 PMCID: PMC6397447 DOI: 10.1186/s12931-019-1010-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/20/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a rare disease with a median survival of 3-5 years after diagnosis with limited treatment options. The aim of this study is to assess the psychometric characteristics of the Short Form 36 Health Status Questionnaire (SF-36) in IPF and to provide disease specific minimally important differences (MID). METHODS Data source was the European IPF Registry (eurIPFreg). The psychometric properties of the SF-36 version 2 were evaluated based on objective clinical measures as well as subjective perception. We analysed acceptance, feasibility, discrimination ability, construct and criterion validity, responsiveness and test-retest-reliability. MIDs were estimated via distribution and anchor-based approaches. RESULTS The study population included 258 individuals (73.3% male; mean age 67.3 years, SD 10.7). Of them 75.2% (194 individuals) had no missing item. The distribution of several items was skewed, although floor effect was acceptable. Physical component score (PCS) correlated significantly and moderately with several anchors, whereas the correlations of mental component score (MCS) and anchors were only small. The tests showed mainly significant lower HRQL in individuals with long-term oxygen therapy. Analyses in stable individuals did not show significant changes of HRQL except for one dimension and anchor. Individuals with relevant changes of the health status based on the anchors had significant changes in all SF-36 dimensions and summary scales except for the dimension PAIN. PCS and MCS had mean MIDs of five and six, respectively. Mean MIDs of the dimensions ranged from seven to 21. CONCLUSION It seems that the SF-36 is a valid instrument to measure HRQL in IPF and so can be used in RCTs or individual monitoring of disease. Nevertheless, the additional evaluation of longitudinal aspects and MIDs can be recommended to further analyse these factors. Our findings have a great potential impact on the evaluation of IPF patients. TRIAL REGISTRATION The eurIPFreg and eurIPFbank are listed in https://clinicaltrials.gov ( NCT02951416 ).
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Affiliation(s)
- Sabine Witt
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), Neuherberg, Germany
| | - Ekaterina Krauss
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Marburg, Germany
| | | | - Veronika Müller
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Philippe Bonniaud
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Reference Center for Rare Pulmonary Diseases, Centre Hospitalier Universitaire Dijon-Bourgogne, INSERMU1231, Université Bourgogne/Franche-Comté, Dijon, France
| | - Carlo Vancheri
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Department of Clinical and Molecular Biomedicine, Università degli Studi di Catania, Catania, Italy
| | - Athol U. Wells
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
| | - Martina Vasakova
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- First Faculty of Medicine, Thomayer University Hospital Prague, Prague, Czech Republic
| | - Alberto Pesci
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Ospedale San Gerardo, Monza, Italy
| | - Walter Klepetko
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Department of Thoracic Surgery, Vienna University Hospital, Vienna, Austria
| | - Werner Seeger
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Marburg, Germany
- Cardio-Pulmonary Institute (CPI), EXC 2026, Project ID: 390649896, Justus-Liebig University Giessen , Giessen, Germany
| | - Bruno Crestani
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Institut National de la Santé et de la Recherche Médicale (INSERM 700), Hôpital Bichat, Service de Pneumologie, Paris, France
| | - Reiner Leidl
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), Neuherberg, Germany
- Ludwig-Maximilians-University, Munich Center of Health Sciences, Munich, Germany
| | - Rolf Holle
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), Neuherberg, Germany
| | - Larissa Schwarzkopf
- Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Health Economics and Health Care Management, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), Neuherberg, Germany
| | - Andreas Guenther
- European IPF Registry & Biobank (eurIPFreg/bank), Giessen, Germany
- Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Center for Lung Research (DZL), Giessen, Marburg, Germany
- Cardio-Pulmonary Institute (CPI), EXC 2026, Project ID: 390649896, Justus-Liebig University Giessen , Giessen, Germany
- AGAPLESION Lung Clinic Waldhof-Elgershausen, Greifenstein, Germany
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Abstract
Sarcoidosis is a complex, polygenic disease of unknown cause with diverse clinical phenotypes, ranging from self-limited, asymptomatic disease to life-altering symptoms and early disease-related mortality. It is unlikely that a single common environmental exposure (e.g., infection, antigen) entirely explains the disease, and numerous genetic mutations are associated with the disease. As such, it is reasonable to assume, as with other phenotypically diverse diseases, that distinct genetic mechanisms and related biological biomarkers will serve to further define sarcoidosis subphenotypes, mechanisms, and possibly etiology, thus guiding personalized care. The fields of "omics" and systems biology research are widely applied to understand polygenic and phenotypically diverse diseases, such as sarcoidosis. "Omics" refers to technologies that allow comprehensive profiling of sets of molecules in an organism. Systems biology applies advanced computational approaches to make sense of the enormous data sets that are typically generated from "omics" platforms. The primary objectives of this article are to review the available "omics" tools, assess the current status of "omics" and systems biology research in the field of sarcoidosis, and consider how this technology could be applied to advance our understanding of the mechanistic underpinnings of disease and to develop novel treatments.
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Overgaard D, Kaldan G, Marsaa K, Nielsen TL, Shaker SB, Egerod I. The lived experience with idiopathic pulmonary fibrosis: a qualitative study. Eur Respir J 2016; 47:1472-80. [PMID: 26846831 DOI: 10.1183/13993003.01566-2015] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 12/14/2015] [Indexed: 11/05/2022]
Abstract
The disease course in idiopathic pulmonary fibrosis (IPF) is variable, but patients experience a progressive decline in lung function and increased symptom burden leading to death. Little is known about the patients' experience and their needs during the disease course or about the burden on family caregivers. Both patients and family caregivers face an altered life as the disease progresses. The aim of our study was to increase knowledge of life with IPF for patients and family caregivers.This study had a qualitative descriptive design using in-depth dyadic interviews with IPF patients (n=25) and family caregivers (n=24). We used the five-step analysis from the framework method and analysed the data on three levels: the patient, the family caregivers and couple level.The following six themes emerged as the main results: information and disclosure, reactional dyssynchrony, perpetual vigilance, emotional ambivalence, gradual and tacit role shift, and adapted coping strategies.Our findings suggest that IPF patients need information at the time of diagnosis, but some issues should be paced as the disease progresses. A palliation plan was demanded by patients and their caregivers. Further efforts are required to provide palliative care to IPF patients starting at the time of diagnosis.
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Affiliation(s)
- Dorthe Overgaard
- Dept of Nursing, Metropolitan University College, Copenhagen, Denmark
| | - Gudrun Kaldan
- Dept of Pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer Marsaa
- Dept of Pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Thyge Lynghøj Nielsen
- Dept of Pulmonary and Infectious Diseases, Nordsjællands Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Saher Burhan Shaker
- Dept of Respiratory Medicine, Herlev-Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid Egerod
- Trauma Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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O'Brien EC, Durheim MT, Gamerman V, Garfinkel S, Anstrom KJ, Palmer SM, Conoscenti CS. Rationale for and design of the Idiopathic Pulmonary Fibrosis-PRospective Outcomes (IPF-PRO) registry. BMJ Open Respir Res 2016; 3:e000108. [PMID: 26835134 PMCID: PMC4716211 DOI: 10.1136/bmjresp-2015-000108] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/09/2015] [Accepted: 12/12/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a chronic interstitial lung disease characterised by progressive loss of lung function. Its clinical course is variable but ultimately fatal. There is a need for a multicentre patient registry incorporating longitudinal clinical data and biological samples to improve understanding of the natural history of IPF and contemporary practice patterns. METHODS/DESIGN The Idiopathic Pulmonary Fibrosis-PRospective Outcomes (IPF-PRO) registry is a national IPF registry in the USA. This registry will enrol approximately 300 patients with newly diagnosed IPF over 2 years at approximately 14 tertiary pulmonary care sites. Participants will be followed for 3-5 years and will receive usual care, as defined by their physician. Clinical data from the year prior to diagnosis will be collected from medical record review on enrolment. Subsequently, data on diagnostic evaluations, pulmonary function tests, physical examinations, laboratory data and clinical events will be collected at routine clinical visits and via a call centre. Participants will complete patient-reported outcome questionnaires at enrolment and then at approximately 6-month intervals. Blood samples for cellular, genetic and transcriptomic analyses will be collected at the same intervals. RESULTS The first results from the IPF-PRO registry will be presented in 2015. CONCLUSIONS The IPF-PRO registry will improve understanding of the natural history of IPF, its impact on patients and current practice in the diagnosis and care of patients with IPF. The registry will establish a repository of biological samples from a well-characterised patient population for future research. CLINICAL TRIAL NUMBER NCT01915511.
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Affiliation(s)
- Emily C O'Brien
- Department of Medicine, Duke University, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Michael T Durheim
- Department of Medicine, Duke University, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Victoria Gamerman
- Biometrics and Data Management, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut, USA
| | - Sandy Garfinkel
- Clinical Operations, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut, USA
| | - Kevin J Anstrom
- Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Scott M Palmer
- Department of Medicine, Duke University, Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Craig S Conoscenti
- Clinical Development and Medical Affairs, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, Connecticut, USA
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Sampson C, Gill BH, Harrison NK, Nelson A, Byrne A. The care needs of patients with idiopathic pulmonary fibrosis and their carers (CaNoPy): results of a qualitative study. BMC Pulm Med 2015; 15:155. [PMID: 26637194 PMCID: PMC4670492 DOI: 10.1186/s12890-015-0145-5] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/18/2015] [Indexed: 01/01/2023] Open
Abstract
Background Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrotic interstitial lung disease of unknown origin. It has a median survival of three years but a wide range in survival rate which is difficult to predict at the time of diagnosis. Specialist guidance promotes a patient centred approach emphasising regular assessment, information giving and supportive care coordinated by a multidisciplinary team (MDT). However understanding of patient and carer experience across the disease trajectory is limited and detailed guidance for MDTs on communication, assessment, and triggers for supportive and palliative interventions is lacking. This study addresses uncertainties relating to care needs of patients and carers at different stages of the IPF disease trajectory. Methods Following ethical approval a multi-centre mixed-methods study recruited participants with IPF at four stages of the disease trajectory. Qualitative analysis was used to analyse 48 semi-structured interviews with patients (27) and paired carers (21). Results Patients and carers outlined key elements of MDT activity capable of having significant impact on the care experience. These were structured around:Focus of clinical encounters Timely identification of changes in health status and functional activity Understanding of symptoms and medical interventions Coping strategies and carer roles.
Conclusions Patients diagnosed with IPF have a clear understanding of their prognosis but little understanding of how their disease will progress and how it will be managed. In depth analysis of the experiences of patients and carers offers guidance for refining IPF clinical pathways. This will support patients and carers at key transition points in line with National Institute for Health and Care Excellence (NICE) guidance. Electronic supplementary material The online version of this article (doi:10.1186/s12890-015-0145-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cathy Sampson
- Cardiff University School of Medicine, Marie Curie Palliative Care Research Centre, Heath Park, Cardiff, CF14 4YS, UK.
| | - Ben Hope Gill
- Department Respiratory Medicine, University Hospital Llandough, Cardiff, UK.
| | | | - Annmarie Nelson
- Cardiff University School of Medicine, Marie Curie Palliative Care Research Centre, Heath Park, Cardiff, CF14 4YS, UK.
| | - Anthony Byrne
- Cardiff University School of Medicine, Marie Curie Palliative Care Research Centre, Heath Park, Cardiff, CF14 4YS, UK.
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Bridges JFP, Paly VF, Barker E, Kervitsky D. Identifying the Benefits and Risks of Emerging Treatments for Idiopathic Pulmonary Fibrosis: A Qualitative Study. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2014; 8:85-92. [DOI: 10.1007/s40271-014-0081-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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