European Clinical Respiratory Journal最新文献

{"title":"Anxiety and depression in women with asthma prior to fertility treatment.","authors":"Emilia Yifei Huang,&nbsp;Anne Vejen Hansen,&nbsp;Casper Tidemandsen,&nbsp;Nina la Cour Freiesleben,&nbsp;Henriette Svarre Nielsen,&nbsp;Vibeke Backer,&nbsp;Charlotte Suppli Ulrik","doi":"10.1080/20018525.2023.2221376","DOIUrl":"https://doi.org/10.1080/20018525.2023.2221376","url":null,"abstract":"<p><strong>Objective: </strong>We investigate symptoms of anxiety and depression among women with asthma prior to fertility treatment.</p><p><strong>Methods: </strong>This is a cross-sectional study of women screened for eligibility to the PRO-ART study (RCT of omalizumab versus placebo in asthmatic women undergoing fertility treatment (NCT03727971)). All participants were scheduled for in vitro fertilization (IVF) treatment at four public fertility clinics in Denmark. Data on demographics and asthma control (ACQ-5) were obtained. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS-A and D, respectively) and defined as being present on both subscales if a score >7 was obtained. Spirometry, diagnostic asthma test, and measurement of fractional exhaled nitric oxide (FeNO) were conducted.</p><p><strong>Results: </strong>A total of 109 women with asthma were included (mean age 31.8 ± 4.6 and BMI 25.5 ± 4.6). Most women had male factor infertility (36.4%) or unexplained infertility (35.5%). Twenty-two percent of the patients reported uncontrolled asthma (ACQ-5 score > 1.5). The mean HADS-A and HADS-D scores were 6.0 ± 3.8 (95% CI 5.3-6.7) and 2.5 ± 2.2 (95% CI 2.1-3.0), respectively. Thirty (28.0%) women reported anxiety symptoms, and four (3.7%) had concomitant depressive symptoms. Uncontrolled asthma was significantly associated with both depressive (<i>p</i> = 0.04) and anxiety symptoms (<i>p</i> = 0.03).</p><p><strong>Conclusions: </strong>More than 25% of women with asthma prior to fertility treatment had self-reported symptoms of anxiety, and just below 5% had self-reported depressive symptoms, possibly related to uncontrolled asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/03/ZECR_10_2221376.PMC10259298.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual communication is commonly used in Finnish interstitial lung disease multidisciplinary meetings.","authors":"Johanna Salonen,&nbsp;Hanna Nurmi,&nbsp;Ulla Hodgson,&nbsp;Hannele Hasala,&nbsp;Maritta Kilpeläinen,&nbsp;Maria Hollmen,&nbsp;Minna Purokivi,&nbsp;Riitta Kaarteenaho","doi":"10.1080/20018525.2023.2190210","DOIUrl":"https://doi.org/10.1080/20018525.2023.2190210","url":null,"abstract":"<p><p>Multidisciplinary meeting (MDM) is a core element in the diagnosis of interstitial lung diseases (ILD). The aim of the study was to investigate the implementation and key elements related to ILD MDMs in Finnish specialized care, which is characterized by long travel distances and a large number of small centers treating patients suffering from ILDs. An electronic questionnaire was sent to ILD experts working at five academic centers of Finland regarding the implementation of ILD MDMs with the focus on utilization of virtual communication. Responses were received from all academic centers of Finland (<i>n</i> = 5) whose catchment areas cover all of Finland. ILD MDMs were organized in each center approximately every two weeks and the core participants included a radiologist, respiratory physicians, junior staff, pathologist and a rheumatologist. All non-academic centers could refer their patients to be evaluated in ILD MDM of an academic center. Virtual communication was utilized by all academic centers in the implementation of ILD MDMs, being most common among small centers located in Eastern and Northern Finland. Virtual access to ILD MDM of an academic center was available in most parts of Finland, enabling small centers to benefit from the ILD expertise of academic centers.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/f8/ZECR_10_2190210.PMC10026813.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9159703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbid conditions as predictors of mortality in severe COPD - an eight-year follow-up cohort study.","authors":"Gabriella Eliasson,&nbsp;Christer Janson,&nbsp;Gunnar Johansson,&nbsp;Kjell Larsson,&nbsp;Anders Lindén,&nbsp;Claes-Göran Löfdahl,&nbsp;Thomas Sandström,&nbsp;Josefin Sundh","doi":"10.1080/20018525.2023.2181291","DOIUrl":"https://doi.org/10.1080/20018525.2023.2181291","url":null,"abstract":"<p><strong>Purpose: </strong>Co-morbidities are common in chronic obstructive pulmonary disease (COPD) and are associated with increased morbidity and mortality. The aim of the present study was to explore the prevalence of several comorbid conditions in severe COPD, and to investigate and compare their associations with long-term mortality.</p><p><strong>Methods: </strong>In May 2011 to March 2012, 241 patients with COPD stage 3 or 4 were included in the study. Information was collected on sex, age, smoking history, weight and height, current pharmacological treatment, number of exacerbations the recent year and comorbid conditions. At December 31st, 2019, mortality data (all-cause and cause specific) were collected from the National Cause of Death Register. Data were analyzed using Cox-regression analysis with gender, age, previously established predictors of mortality and comorbid conditions as independent variables, and all-cause mortality and cardiac and respiratory mortality, respectively, as dependent variables.</p><p><strong>Results: </strong>Out of 241 patients, 155 (64%) were deceased at the end of the study period; 103 patients (66%) died of respiratory disease and 25 (16%) of cardiovascular disease. Impaired kidney function was the only comorbid condition independently associated with increased all-cause mortality (HR (95% CI) 3.41 (1.47-7.93) p=0.004) and respiratory mortality (HR (95%CI) 4.63 (1.61 to 13.4), p = 0.005). In addition, age ≥70, BMI <22 and lower FEV1 expressed as %predicted were significantly associated with increased all-cause and respiratory mortality.</p><p><strong>Conclusion: </strong>In addition to the risk factors high age, low BMI and poor lung function; impaired kidney function appears to be an important risk factor for mortality in the long term, which should be taken into account in the medical care of patients with severe COPD.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d3/d2/ZECR_10_2181291.PMC9970194.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10821302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, risk factors, and recurrence risk of persistent air leak in patients with secondary spontaneous pneumothorax.","authors":"Hei-Shun Cheng,&nbsp;Yi-Tat Lo,&nbsp;Flora Pui-Ling Miu,&nbsp;Loletta Kit-Ying So,&nbsp;Loretta Yin-Chun Yam","doi":"10.1080/20018525.2023.2168345","DOIUrl":"https://doi.org/10.1080/20018525.2023.2168345","url":null,"abstract":"<p><strong>Background: </strong>Persistent air leak (PAL) is common in secondary spontaneous pneumothorax (SSP), with risk factors only been determined for post-pulmonary resection PAL. Information about its risk factors and long-term outcome is, however, necessary to enable selection of treatment modalities for elderly SSP patients with comorbid conditions.</p><p><strong>Methods: </strong>A retrospective observational study was performed on chest drain-treated SSP patients from 2009 to 2018. The risk factors, long-term recurrent pneumothorax, and mortality rates of those with and without PAL were evaluated.</p><p><strong>Results: </strong>Of 180 non-surgical SSP patients, PAL prevalence for >2 days and >7 days were 81.1% and 43.3%, respectively. Bulla was associated with PAL >7 days (OR: 2.32; P: 0.027) and serum albumin negatively associated (OR: 0.94; P: 0.028). PAL resulted in longer hospitalization in the index episode (P: <0.01). PAL >7 days was associated with a higher pneumothorax recurrence rate in three months (HR: 2.65; P: 0.041), one year (HR: 2.50; P: 0.040) and two-year post-discharge (HR: 2.40; P: 0.029). Patients treated with medical pleurodesis were significantly older (P: <0.01), had higher Charlson Co-morbidity index scores (P: <0.01), and 77.8% of those who had PAL >7 days were considered unfit for surgery. Of these, pneumothorax had not recurred in 69.4% after two years (HR: 0.47; P: 0.044).</p><p><strong>Conclusion: </strong>Bulla was positively associated with PAL over seven days in SSP patients while albumin was negatively associated. PAL over seven days increased future recurrent pneumothorax risks, while elderly SSP patients unfit for surgery had acceptable recurrence rates after medical pleurodesis.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/05/ZECR_10_2168345.PMC9897746.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10718227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic corticosteroids in treatment of chronic rhinosinusitis-A systematic review.","authors":"Sarah Tamene,&nbsp;Kim Dalhoff,&nbsp;Peter Schwarz,&nbsp;Vibeke Backer,&nbsp;Kasper Aanaes","doi":"10.1080/20018525.2023.2240511","DOIUrl":"https://doi.org/10.1080/20018525.2023.2240511","url":null,"abstract":"<p><strong>Purpose: </strong>When first-line chronic rhinosinusitis (CRS) treatment fails, patients can either be treated with oral or injected systemic corticosteroids. Although the EPOS and international guidelines for CRS do not mention injected corticosteroids, it is commonly used by ear, nose, and throat specialists. While the risks of systemic corticosteroids, in general, are known, the pros and cons of injected and oral corticosteroids (OCS) in CRS treatment are unclear.</p><p><strong>Methods: </strong>A systematic review of studies that report the effects and/or side effects of injected and oral corticosteroids in the treatment of CRS was made according to the PRISMA guidelines.</p><p><strong>Results: </strong>Altogether, 48 studies were included, only five studies reported on injected corticosteroids, and five attended with side effects. Three studies found beneficial effects of OCS perioperatively on sinus surgery, while four articles found no effect. Nineteen articles reported that OCS resulted in an improvement in symptoms. Two articles presented a longer-lasting effect of injected corticosteroids than OCS. Three studies reported adverse side effects of systemic corticosteroids, while two studies showed no adverse side effects. One study showed less adrenal suppression after injected corticosteroids compared to OCS. The evidence is not strong but shows a positive effect of systemic corticosteroids that lasts longer with injections.</p><p><strong>Conclusion: </strong>Although systemic corticosteroids are widely used to treat CRS, there is a lack of studies comparing the OCS and injected corticosteroids. The evidence is sparse, however, injected steroids show longer effects with fewer side effects. An RCT study is needed to compare OCS and injected corticosteroids.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/76/64/ZECR_10_2240511.PMC10405757.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10193432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of aerobic exercise training on asthma control in postmenopausal women (ATOM): a randomized controlled pilot study.","authors":"Erik Sören Halvard Hansen,&nbsp;Hanne Kruuse Rasmusen,&nbsp;Morten Hostrup,&nbsp;Ylva Hellsten,&nbsp;Vibeke Backer","doi":"10.1080/20018525.2023.2251256","DOIUrl":"https://doi.org/10.1080/20018525.2023.2251256","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate if high-intensity interval training three times weekly for 12 weeks improves asthma control in overweight, postmenopausal women with uncontrolled, late-onset asthma.</p><p><strong>Methods: </strong>The reported study is a randomized clinical pilot study (www.clinicaltrials.gov; NCT03747211) that compared 12 weeks of high-intensity interval training (spinning) with usual care. The five-question Asthma Control Questionnaire (ACQ-5) was used as primary outcome. Secondary measures included systemic inflammation and inflammation of the airways, body composition, and cardiac function during exercise.</p><p><strong>Results: </strong>We included 12 women with asthma (mean age 65 years (SD 6); mean body mass index 30 kg/m² (SD 2)) from whom eight were randomized to exercise and four to control. Baseline ACQ-5 was 1.95 (SD 0.53) in the control group and 2.03 (0.54) in the exercise group. Patients had a mean blood eosinophil level of 0.16 × 10⁹cells/L (SD 0.07) and a mean fraction of exhaled nitric oxide of 23 ppb (SD 25). Mixed models showed that participants in the exercise group reduced their ACQ-5 by 0.55 points (95%CI -1.10 to -0.00; <i>P</i> = 0.08) compared with the control group. The exercise group significantly reduced their mean body fat percentage (-2.7%; 95%CI -4.5 to -0.8; <i>P</i> = 0.02), fat mass (-2.8 kg; 95%CI -5.1 to -0.4; <i>P</i> = 0.044) and android fat mass (-0.33 kg; 95%CI -0.60- -0.06; <i>P</i> = 0.038). In analyses of cardiac measures, we saw no significant effects on right ventricular function (fractional area change), diastolic function or left ventricular function.</p><p><strong>Conclusions: </strong>Although changes in ACQ-5 were slightly insignificant, these preliminary findings indicate that aerobic exercise training can be used as a means to improve asthma control in overweight, postmenopausal women with asthma.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/54/ZECR_10_2251256.PMC10478610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxemia and not hyperoxemia predicts worse outcome in severe COPD exacerbations - an observational study.","authors":"Charlotte Sandau,&nbsp;Ejvind Frausing Hansen,&nbsp;Lars Pedersen,&nbsp;Jens Ulrik Stæhr Jensen","doi":"10.1080/20018525.2022.2153644","DOIUrl":"https://doi.org/10.1080/20018525.2022.2153644","url":null,"abstract":"<p><strong>Objectives: </strong>For patients admitted with an acute exacerbation of COPD (AECOPD) and a need for supplementary oxygen therapy, to determine if peripheral oxygen saturation < 88% (hypoxemia) or >92% (hyperoxemia), within first 24 hours of admission, is associated with 'treatment failure' or fewer days alive and out of hospital within 14 days after admission.</p><p><strong>Design: </strong>A retrospective multicenter observational study, reviewing consecutive data on SpO2, oxygen, and drug administration at three predefined time points, on adverse events in patients admitted with COPD between December 2019 and June 2020. Multivariable logistic regression analysis, Mann Whitney U- and Chi-square-test were used.</p><p><strong>Setting: </strong>Acute hospital setting, across four different hospitals in the capital region of Denmark.</p><p><strong>Participants: </strong>Patients with a confirmed diagnosis of COPD admitted with an acute exacerbation and an oxygen need within the first 24 hours admission.</p><p><strong>Results: </strong>In total 289 COPD patients were included. The median age was 74.8 years [interquartile range (IQR):69.6 to 81.8], 191 were female and 132 patients experienced 'treatment failure'. A minimum of one episode of hypoxemia (SpO₂ < 88%) within first 24 hours was associated with having a low number (≤4) of days alive and out of hospital within 14 days after admission: OR 2.4 (95%CI 1.2 to 4.8), p = 0.02, absolute risk 44% vs. 26% p = 0.01, Chi-square. Comparable results were observed after 30 days of follow-up: OR 2.6 (95% CI 1.0 to7.1), p = 0.05. A minimum of one measurement of hyperoxemia (SpO₂ > 92%), within first 24 hours of admission was not associated with low number of days alive and out of hospital within 14 days OR 1.0 (95% CI 0.5 to 2.1) nor at 30 days.</p><p><strong>Conclusion: </strong>For admitted patients with AECOPD, being hypoxemic ever within the first 24 hours after admission is associated with a substantially increased risk of a poor prognosis.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/39/ZECR_10_2153644.PMC9731582.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10698430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Danish respiratory society guideline for long-term high flow nasal cannula treatment, with or without supplementary oxygen.","authors":"Ulla Møller Weinreich,&nbsp;Kasper Svendsen Juhl,&nbsp;Malene Søby Christophersen,&nbsp;Svend Gundestrup,&nbsp;Munsoor Ali Hanifa,&nbsp;Kristine Jensen,&nbsp;Frank Dyekjær Andersen,&nbsp;Ole Hilberg,&nbsp;Line Hust Storgaard","doi":"10.1080/20018525.2023.2178600","DOIUrl":"https://doi.org/10.1080/20018525.2023.2178600","url":null,"abstract":"<p><strong>Introduction: </strong>Long-term High Flow Nasal Cannula (LT-HFNC), defined as High Flow Nasal Cannula treatment provided to patients with chronic pulmonary conditions during stable phases, has emerged as a home treatment in different categories of patients with chronic lung diseases in recent years.</p><p><strong>Methods: </strong>This paper summarizes the physiological effects of LT-HFNC and evaluates the clinical knowledge to date about treatment in patients with chronic obstructive lung disease, interstitial lung disease and bronchiectasis. The guideline is translated and summarized in this paper and presented unabridged as an appendix to the paper.</p><p><strong>Results: </strong>The paper describes the working process behind the Danish Respiratory Society's National guideline for treatment of stable disease, which has been written to support clinicians in both evidence-based decision making and practical issues concerning the treatment.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/63/c6/ZECR_10_2178600.PMC9970213.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10812843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective study on immune-related pneumonitis in patients with non-small-cell lung cancer undergoing treatment with PD-1/PD-L1 inhibitors.","authors":"Dorthe Yakymenko,&nbsp;Kristin Skougaard","doi":"10.1080/20018525.2023.2194162","DOIUrl":"https://doi.org/10.1080/20018525.2023.2194162","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer patients undergoing treatment with immune checkpoint inhibitors (ICIs) are at risk of developing immune-related (ir-)pneumonitis. Since lung cancer patients have competing reasons for respiratory symptoms, this poses a diagnostic challenge. This study aimed to explore diagnosis and management of ir-pneumonitis in this patient group.</p><p><strong>Materials and methods: </strong>Suspected ir-pneumonitis was frequent in this group of patients. The cohort was characterized by high heterogeneity and lack of unequivocal diagnostic conclusions. Treatment of ir-pneumonitis was longer than recommended and involvement of pulmonologist was very infrequent. The result of this study reflects the difficulties in a daily clinical setting to diagnose and manage patients with lung cancer presenting with pulmonary symptoms.</p><p><strong>Results: </strong>Suspected ir-pneumonitis was frequent in this group of patients. The cohort was characterized by high heterogeneity and lack of unequivocal diagnostic conclusions. Treatment of ir-pneumonitis was longer than recommended and involvement of pulmonologist was very infrequent. The result of this study reflects the difficulties in a daily clinical setting to diagnose and manage patients with lung cancer presenting with pulmonary symptoms.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/11/2a/ZECR_10_2194162.PMC10071953.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9640143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The diagnostic trajectories of Danish patients with autoimmune rheumatologic disease associated interstitial lung disease: an interview-based study.","authors":"M B Johansen,&nbsp;E Bendstrup,&nbsp;J R Davidsen,&nbsp;S B Shaker,&nbsp;H M Martin","doi":"10.1080/20018525.2023.2178601","DOIUrl":"https://doi.org/10.1080/20018525.2023.2178601","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune rheumatologic disease associated interstitial lung diseases (ARD-ILD) are rare conditions and the association between ARDs and respiratory symptoms often goes unrecognised by ARD patients and general practitioners (GPs). The diagnostic trajectory from the first respiratory symptoms to an ARD-ILD diagnosis is often delayed and may increase the burden of symptoms and allow further disease progression.The aim of this study was to 1) characterise the diagnostic trajectories of ARD-ILD patients and to 2) identify barriers for obtaining a timely ILD diagnosis based on the experiences and perceptions of both patients and healthcare professionals.</p><p><strong>Method: </strong>Semi-structured qualitative interviews were conducted with Danish ARD-ILD patients, rheumatologists, pulmonologists and ILD nurses.</p><p><strong>Results: </strong>Sixteen patients, six rheumatologists, three ILD nurses and three pulmonologists participated. Five characteristics of diagnostic trajectories were identified in the patient interviews: 1) early referral to lung specialists; 2) early delay; 3) delay or shortcut depending on specific circumstances; 4) parallel diagnostic trajectories connected late in the process; 5) early identification of lung involvement without proper interpretation. With the exception of early referral to lung specialists, all of the diagnostic trajectory characteristics identified led to delayed diagnosis. Delayed diagnostic trajectories resulted in patients experiencing increased uncertainty. Inconsistent disease terminology, insufficient knowledge and lack of awareness of ARD-ILD among central healthcare professionals and delayed referral to ILD specialists were main contributors to the diagnostic delay identified by the informants.</p><p><strong>Conclusion: </strong>Five characteristics of the diagnostic trajectories were identified, four of which led to diagnostic delay of ARD-ILD. Improved diagnostic trajectories can shorten the diagnostic trajectory and increase early access to appropriate specialist medical care. Improved awareness and expertise in ARD-ILD across different medical specialties, especially among GPs, may contribute to more efficient and timely diagnostic trajectories and improved patient experiences.</p>","PeriodicalId":11872,"journal":{"name":"European Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/69/ZECR_10_2178601.PMC9987749.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9082456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}