Physician characteristics associated with treatment initiation patterns in idiopathic pulmonary fibrosis. (26th September 2019)

• Record Type: Journal Article
• Authors: LaCamera, Peter P; Limb, Susan L; Haselkorn, Tmirah; Morgenthien, Elizabeth A; Stauffer, John L; Wencel, Mark L
• Is Part Of: Chronic respiratory disease. Volume 16(2019)
• Publication Date: 2019-09-26
• Subjects: Antifibrotic therapy -- idiopathic pulmonary fibrosis; Respiratory organs -- Diseases -- Periodicals; 616.2005
• DOI: 10.1177/1479973119879678
• Languages: English
• ISSNs: 1479-9723

Abstract

Pirfenidone and nintedanib are oral antifibrotic agents approved for the treatment of idiopathic pulmonary fibrosis (IPF). Real-world data on factors that influence IPF treatment decisions are limited. Physician characteristics associated with antifibrotic therapy initiation following an IPF diagnosis were examined in a sample of US pulmonologists. An online, self-administered survey was fielded to pulmonologists between April 10, 2017, and May 17, 2017. Pulmonologists were included if they spent >20% of their time in direct patient care and had ≥5 patients with IPF receiving antifibrotics. Participants answered questions regarding timing and reasons for considering the initiation of antifibrotic therapy after an IPF diagnosis. A total of 169 pulmonologists participated. The majority (81.7%) considered initiating antifibrotic therapy immediately after IPF diagnosis all or most of the time (immediate group), while 18.3% considered it only some of the time or not at all (delayed group). Pulmonologists in the immediate group were more likely to work in private practice (26.1%), have a greater mean percentage of patients receiving antifibrotic therapy (60.8%), and decide to initiate treatment themselves (31.2%) versus those in the delayed group (16.1%, 30.5%, and 16.1%, respectively). Most pulmonologists consider initiating antifibrotic treatment immediately after establishing an IPF diagnosis all or most of the time versus using a "watch-and-wait" approach. Distinguishing characteristics between pulmonologists in the immediate group versus the delayed group included practice setting, percentage of patients receiving antifibrotic therapy, and the decision-making dynamics between the patient and the pulmonologist.