Physicians' Perspectives and Practice Patterns in India on the Diagnosis and Treatment of Interstitial Lung Disease (IN-ILD Survey)
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Date
2024-06
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Publisher
Jaypee Brothers Medical Publishers Pvt. Ltd.
Abstract
Aim and background: Data on clinicians’ views and practice patterns regarding interstitial lung disease (ILD) management in India is currently lacking. The objective of this survey was to understand clinicians’ perspectives on the diagnosis and treatment of patients with ILDs. Materials and methods: This was a questionnaire-based survey conducted among clinicians attending continuing medical education programs on ILDs across India in February 2020. Data entry and statistical analysis were done for completed questionnaires and results are expressed in terms of percentages based on the number of responses obtained. Results: A total of 321 clinicians managing ILDs participated in this survey, of which 87.75% were pulmonologists. Chronic hypersensitivity pneumonitis was ranked as the most common ILD seen in clinical practice, followed by idiopathic pulmonary fibrosis (IPF), connective tissue-ILD, and sarcoidosis. In total 43% of respondents preferred a combination of clinical evaluation, high-resolution computed tomography, and serology for ILD diagnosis. In the case of a planned biopsy, transbronchial lung biopsy (50.17%) was most preferred for idiopathic interstitial pneumonia. For follow-up, spirometry (86.60%) and a 6-minute walk distance (78.19%) were the most commonly performed tests. Antifibrotics (63.42%) were the preferred treatment for IPF while steroids either alone or in combination with immunosuppressants were preferred for non-IPF ILDs. Only 50% of respondents opined that pirfenidone 1800 mg/day and above was tolerated by over 45% of their IPF patients. Conclusion: Management of ILD has improved significantly in India. Antifibrotic dosing remains suboptimal in IPF. In non-IPF ILDs, a significant number of clinicians now use alternative immunosuppressants to steroids.
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Keywords
Antifibrotic, Clinician survey, Diagnosis, Idiopathic pulmonary fibrosis, Immunosuppressant, India, Interstitial lung disease, Pirfenidone
Citation
Rajan Sujeet K, Meshram Sushant, Chhajed Prashant, Mehta Monali, Lopez Meena, Gogtay Jaideep . Physicians' Perspectives and Practice Patterns in India on the Diagnosis and Treatment of Interstitial Lung Disease (IN-ILD Survey) . The Indian Journal of Chest Diseases and Allied Sciences. 2024 Jun; 66(2): 44-53