RT Journal Article
SR Electronic
T1 Dynamics in diagnoses and pharmacotherapy before and after diagnosing idiopathic pulmonary fibrosis
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00479-2020
DO 10.1183/23120541.00479-2020
VO 6
IS 4
A1 Jesper Rømhild Davidsen
A1 Lars Christian Lund
A1 Christian B. Laursen
A1 Jesper Hallas
A1 Daniel Pilsgaard Henriksen
YR 2020
UL http://openres.ersjournals.com/content/6/4/00479-2020.abstract
AB Background Idiopathic pulmonary fibrosis (IPF) is a well-characterised interstitial lung disease. Typically, IPF diagnosis is delayed due to nonspecific 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 between 2002 and 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, 10 random controls were recruited for each case.Results A total of 650 IPF patients were identified (median age 73 years (interquartile range 65–78), 70.3% males). Prior to the IPF diagnosis, the most prevalent diagnoses were dyspnoea and non-IPF interstitial lung diseases. 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.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. https://bit.ly/3bAzveS