Alison M. DeDent MAS, MD , Jessica E. Shore PhD, RN , Rebecca Bascom MD, MPH , Janell Reichuber APRN , Mary Beth Scholand MD , Ryan Boente MD , Anoop M. Nambiar MS, MD , Sonye K. Danoff MD, PhD , Franck Rahaghi MD, MHS , Tejaswini Kulkarni MD, MPH , Hyun Joo Kim MD , Pulmonary Fibrosis Foundation Rural Health Outreach Committee
{"title":"Caring for Rural Patients With Interstitial Lung Disease","authors":"Alison M. DeDent MAS, MD , Jessica E. Shore PhD, RN , Rebecca Bascom MD, MPH , Janell Reichuber APRN , Mary Beth Scholand MD , Ryan Boente MD , Anoop M. Nambiar MS, MD , Sonye K. Danoff MD, PhD , Franck Rahaghi MD, MHS , Tejaswini Kulkarni MD, MPH , Hyun Joo Kim MD , Pulmonary Fibrosis Foundation Rural Health Outreach Committee","doi":"10.1016/j.chpulm.2025.100136","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The Pulmonary Fibrosis Foundation Care Center Network (PFF-CCN) provides expertise in the diagnosis and management of interstitial lung diseases (ILDs); however, most centers are in urban areas. Little is known about access to ILD care for patients living in rural areas.</div></div><div><h3>Research Question</h3><div>What are the perspectives of PFF-CCN providers on the accessibility and provision of ILD care for rural patients?</div></div><div><h3>Study Design and Methods</h3><div>A mixed methods survey designed by the Pulmonary Fibrosis Foundation Rural Health Outreach Committee was distributed with weekly reminders to all 68 PFF-CCN sites between November 2021 and February 2022 through REDCap. The survey included 21 closed-ended questions that were analyzed using descriptive statistics and 3 open-ended questions that underwent thematic analysis. Before coding, free text responses were reviewed, and nearly all were sorted into 1 of 2 groups: barriers or facilitators to ILD care. Responses were then coded inductively and sorted into categories, followed by themes drawn from the data. Only 1 survey per PFF-CCN site was analyzed.</div></div><div><h3>Results</h3><div>A total of 68 PFF-CCN sites (providers) completed the survey (100% response rate). Of these, 57% of providers perceived that rural patients often experience delays in diagnosis compared with their urban counterparts, and 47% perceived they often have delays in ILD treatment. The following 3 themes emerged as barriers to ILD care for rural patients: poor access to care (73% of all coded barriers), limited resources (23%), and patient preferences and concerns (3%). Three themes emerged as facilitators to ILD care: local collaboration (49% of all coded facilitators), telemedicine (30%), and patient-centered care (21%).</div></div><div><h3>Interpretation</h3><div>PFF-CCN providers identified several important barriers and facilitators to care for rural patients with ILD occurring at the patient, provider, and health care system levels.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"3 3","pages":"Article 100136"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"CHEST pulmonary","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949789225000030","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The Pulmonary Fibrosis Foundation Care Center Network (PFF-CCN) provides expertise in the diagnosis and management of interstitial lung diseases (ILDs); however, most centers are in urban areas. Little is known about access to ILD care for patients living in rural areas.
Research Question
What are the perspectives of PFF-CCN providers on the accessibility and provision of ILD care for rural patients?
Study Design and Methods
A mixed methods survey designed by the Pulmonary Fibrosis Foundation Rural Health Outreach Committee was distributed with weekly reminders to all 68 PFF-CCN sites between November 2021 and February 2022 through REDCap. The survey included 21 closed-ended questions that were analyzed using descriptive statistics and 3 open-ended questions that underwent thematic analysis. Before coding, free text responses were reviewed, and nearly all were sorted into 1 of 2 groups: barriers or facilitators to ILD care. Responses were then coded inductively and sorted into categories, followed by themes drawn from the data. Only 1 survey per PFF-CCN site was analyzed.
Results
A total of 68 PFF-CCN sites (providers) completed the survey (100% response rate). Of these, 57% of providers perceived that rural patients often experience delays in diagnosis compared with their urban counterparts, and 47% perceived they often have delays in ILD treatment. The following 3 themes emerged as barriers to ILD care for rural patients: poor access to care (73% of all coded barriers), limited resources (23%), and patient preferences and concerns (3%). Three themes emerged as facilitators to ILD care: local collaboration (49% of all coded facilitators), telemedicine (30%), and patient-centered care (21%).
Interpretation
PFF-CCN providers identified several important barriers and facilitators to care for rural patients with ILD occurring at the patient, provider, and health care system levels.