title: Management of idiopathic pulmonary fibrosis in France: a survey of 1244 pulmonologists.
abstract: BACKGROUND
  The present survey coordinated by the French expert centres for rare pulmonary diseases investigated French pulmonologists' current diagnostic and therapeutic practice for idiopathic pulmonary fibrosis (IPF).
  
  
  METHODS
  From December 7, 2011 to February 18, 2012, all French pulmonologists (n = 2608) were contacted. Those who reported following up at least one IPF patient (n = 509) were administered a 26-item questionnaire by phone or e-mail.
  
  
  RESULTS
  509 pulmonologists (41% of responders, 20% of French pulmonologists) were involved in the management of IPF patients. Of those, 36% discussed the cases with radiologists and pathologists. Out of 406 community pulmonologists practicing outside of reference or competence (e.g. expert) centres, 141 (35%) indicated referring patients to those centres. The 2011 international guidelines for IPF were known by 67% of pulmonologists involved in IPF, 84% of whom considered them appropriate for practice. About 58% of patients were diagnosed with mild to moderate IPF as defined by percentage predicted forced vital capacity ≥50% and percentage predicted diffusing capacity of the lung for carbon monoxide ≥35%. Management resulted from multidisciplinary discussion in 36% of the cases. By the end of December 2011, 49% of patients with mild to moderately severe IPF were treated with oral corticosteroids, and 27% received no treatment.
  
  
  CONCLUSIONS
  Despite correct awareness of international IPF guidelines, modalities of multidisciplinary discussion and of early diagnosis and management need to be improved through the network of expert centres.
authors.affiliation: National Reference Centre for Rare Pulmonary Diseases, Louis Pradel University Hospital, Lyon, France. Electronic address: vincent.cottin@chu-lyon.fr.
authors.forename: V
authors.initials: V
authors.lastname: Cottin
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, AP-HP, Tenon Hospital, Pierre & Marie Curie University, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Cadranel
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, Bichat Hospital, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Crestani
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, University Hospital, Besançon, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Dalphin
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, University Hospital, Rennes, France.
authors.forename: P
authors.initials: P
authors.lastname: Delaval
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, AP-HP, Georges Pompidou European Hospital, Paris Descartes University, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Israel-Biet
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, University Hospital, Strasbourg, France.
authors.forename: R
authors.initials: R
authors.lastname: Kessler
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, University Hospital, Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Reynaud-Gaubert
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, AP-HP, Avicenne Hospital, and Université Paris 13, Sorbonne Paris Cité, Bobigny, France.
authors.forename: D
authors.initials: D
authors.lastname: Valeyre
authors.affiliation: Competence Centre for Rare Pulmonary Diseases, University Hospital, Lille, France.
authors.forename: B
authors.initials: B
authors.lastname: Wallaert
authors.affiliation: Opened Mind Health, Roubaix, France.
authors.forename: B
authors.initials: B
authors.lastname: Bouquillon
authors.affiliation: National Reference Centre for Rare Pulmonary Diseases, Louis Pradel University Hospital, Lyon, France.
authors.forename: J F
authors.initials: JF
authors.lastname: Cordier
mesh_terms: D000284:Administration, Oral; D042241:Early Diagnosis; D005602:France; D005938:Glucocorticoids / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D017410:Practice Guidelines as Topic; D011653:Pulmonary Diffusing Capacity; D015272:Pulmonary Medicine; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D005938:Glucocorticoids
keywords: Drug therapy; Idiopathic pulmonary fibrosis; Management; Pirfenidone; Survey