TY - JOUR T1 - Dynamics in diagnoses and pharmacotherapy before and after diagnosing idiopathic pulmonary fibrosis JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00479-2020 SP - 00479-2020 AU - Jesper Rømhild Davidsen AU - Lars Christian Lund AU - Christian B. Laursen AU - Jesper Hallas AU - Daniel Pilsgaard Henriksen Y1 - 2020/01/01 UR - http://openres.ersjournals.com/content/early/2020/09/01/23120541.00479-2020.abstract N2 - Background Idiopathic pulmonary fibrosis (IPF) is a well-characterised interstitial lung disease (ILD). Typically, the IPF diagnosis is delayed due to non-specific symptoms, but can also be delayed due to treatment attempts on false indication, or due to treatment targeting common comorbidities. This observational study aimed to assess the dynamics in the medication and diagnosis patterns in the period before and after an IPF diagnosis.Methods We identified all Danish patients with IPF during 2002 to 2017. We evaluated new and ongoing drug treatments and incident diagnoses 36 months before, and 12 months after an IPF diagnosis by use of Danish nationwide registries. To aid interpretation, ten random controls were recruited for each case.Results A total of 650 IPF patients were identified (median age 73 years [IQR 65–78], 70.3% males). Prior to the IPF diagnosis, the most prevalent diagnoses were dyspnea and non-IPF ILDs. For drug use, IPF patients had higher initiation rates for antibiotics, oral corticosteroids and mucolytics. In terms of drug volume, IPF patients used more respiratory drugs, antibiotics, immunosuppressants, corticosteroids, proton pump inhibitors, benzodiazepines and opium alkaloids within the 6 months preceding their IPF diagnosis, compared to the controls. Overall drug use decreased after an IPF diagnosis, mainly due to a reduced glucocorticoid and cardiovascular drug use.Conclusion Among IPF patients, an increased drug use was observed for diagnoses with symptoms overlapping those of IPF, particularly this was observed during the last 6 months before an IPF diagnosis. This emphasises the need for an increased IPF awareness.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Davidsen reports grants and personal fees from Roche , personal fees and non-financial support from Boehringer Ingelheim, outside the submitted work.Conflict of interest: Dr. Lund reports other from null, outside the submitted work.Conflict of interest: Dr. Laursen has nothing to disclose.Conflict of interest: Dr. Hallas has nothing to disclose.Conflict of interest: Dr. Henriksen has nothing to disclose. ER -