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Opportunities to diagnose fibrotic lung diseases in routine care: A primary care cohort study
Author(s) -
Jones Mark G.,
Hillyar Christopher R.T.,
Nibber Anjan,
Chisholm Alison,
Wilson Andrew,
Maher Toby M.,
Kaplan Alan,
Price David,
Walsh Simon,
Richeldi Luca
Publication year - 2020
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13836
Subject(s) - medicine , cohort , pulmonary fibrosis , sarcoidosis , diagnosis code , primary care , stage (stratigraphy) , idiopathic pulmonary fibrosis , health care , medical record , cohort study , lung , pediatrics , intensive care medicine , emergency medicine , family medicine , population , paleontology , environmental health , economics , biology , economic growth
Background and objective Temporal trends of healthcare use in the period before a diagnosis of pulmonary fibrosis are poorly understood. We investigated trends in respiratory symptoms and LR HRU in the 10 years prior to diagnosis. Methods We analysed a primary care clinical cohort database (UK OPCRD) and assessed patients aged ≥40 years who had an electronically coded diagnosis of pulmonary fibrosis between 2005 and 2015 and a minimum 2 years of continuous medical records prior to diagnosis. Exclusion criteria consisted of electronic codes for recognized causes of pulmonary fibrosis such as CTD, sarcoidosis or EAA. Results Data for 2223 patients were assessed. Over the 10 years prior to diagnosis of pulmonary fibrosis, there was a progressive increase in HRU across multiple LR‐related domains. Five years before diagnosis, 18% of patients had multiple healthcare contacts for LR complaints; this increased to 79% in the year before diagnosis, with 38% of patients having five or more healthcare contacts. Conclusion There are opportunities to diagnose pulmonary fibrosis at an earlier stage; research into case‐finding algorithms and strategies to educate primary care physicians is required.