The interstitial lung disease patient pathway: from referral to diagnosis

BACKGROUND: Suspected interstitial lung disease (ILD) patients may be referred to an ILD-specialist centre or a non-ILD-specialist centre for diagnosis and treatment. Early referral and management of patients at ILD-specialist centres has been shown to improve survival and reduce hospitalisations. The COVID-19 pandemic has affected the ILD patient diagnostic pathway and prompted centres to adapt. This study investigates and contrasts ILD patient pathways in ILD-specialist and non-ILD-specialist centres, focusing on referrals, caseloads, diagnostic tools, multi-disciplinary team (MDT) meeting practices and resource accessibility. METHODS: Conducted as a cross-sectional study, a global self-selecting survey ran from September 2022 to January 2023. Participants included ILD specialists and healthcare professionals (HCPs) from ILD-specialist centres and non-ILD-specialist centres. RESULTS: Of 363 unique respondents from 64 countries, 259 were from ILD-specialist centres and 104 from non-ILD-specialist centres. ILD centres had better resource availability, exhibiting higher utilisation of diagnostic tests (median: 12 tests) than non-ILD centres (nine tests) and better access to specialist professions attending MDT meetings (median: six professions at meeting) in specialist centres than non-ILD centres (three professions at meeting). Transitioning to virtual MDT meetings allowed HCPs from other locations to join meetings in nearly 90% of all centres, increasing regular participation in 60% of specialist centres and 72% of non-ILD centres. For treatment of patients, specialist centres had better access to antifibrotic drugs (91%) compared to non-ILD centres (60%). CONCLUSIONS: Diagnostic pathways for ILD patients diverged between specialist centres and non-ILD centres. Disparities in resource and specialist availability existed between centres.

• Lough, G.
• Abdulqawi, R.
• Amanda, G.
• Antoniou, K.
• Azuma, A.
• Baldi, M.
• Bayoumy, A.
• Behr, J.
• Bendstrup, E.
• Bouros, D.
• Brown, K.
• Chaudhuri, N.
• Corte, T. J.
• Cottin, V.
• Crestani, B.
• Flaherty, K. R.
• Glaspole, I.
• Kawano-Dourado, L.
• Keane, M. P.
• Kolb, M.
• Martinez, F. J.
• Molina-Molina, M.
• Ojanguren, I.
• Pearmain, L.
• Raghu, G.
• Rottoli, P.
• Stanel, S. C.
• Tabaj, G.
• Vancheri, C.
• Varela, B.
• Wang, B.
• Wells, A.
• Rivera-Ortega, P.