An international physician survey of pulmonary arterial hypertension management.
We conducted an international study to evaluate practices in the diagnosis and management of pulmonary arterial hypertension (PAH) globally across different geographic regions. Between July and October 2012, PAH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 3 or 5 most recent patients with PAH. Overall, 560 physicians (Europe: 278; United States: 160; Argentina: 53; Japan: 69) completed the questionnaire and provided data for 2,618 patients. The proportion of physicians who described themselves as working in or affiliated with a specialized pulmonary hypertension center ranged from 13% in Argentina to 74% in the United States. At the time of diagnosis, patients' New York Heart Association functional class differed significantly between regions. At the time of last assessment, functional class had improved overall, and differences between regions had largely disappeared. A large proportion of patients did not undergo right heart catheterization for the diagnosis of PAH (Europe: 7%-21%; United States: 21%; Japan: 19%; Argentina: 51%). Variations in management included greater use of phosphodiesterase 5 inhibitors in the United States than in Europe and Japan and greater use of triple or greater combination therapy in Japan than in other regions. Results from this study, which includes a global aspect of PAH care, demonstrate that there are significant differences in PAH management between regions and low adherence to guidelines recommending right heart catheterization for the diagnosis of PAH.
Pulmonary, Critical Care and Sleep Division, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
Ioana R
IR
Preston
Global Market Research, Bayer Pharma, Berlin, Germany.
Barbara
B
Hinzmann
Ipsos Healthcare, London, United Kingdom.
Sabina
S
Heinz
University of Giessen and Marburg Lung Center (UGMLC), member of the German Center of Lung Research (DZL), Giessen, Germany.
Henning
H
Gall
National Pulmonary Endarterectomy Service, Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge, United Kingdom.
David
D
Jenkins
Division of Pulmonary and Critical Care Medicine, University of California, San Diego, La Jolla, California, USA.
Nick H
NH
Kim
Allgemeines Krankenhaus der Stadt Wien, Vienna, Austria.
Irene
I
Lang
clinical practice; diagnosis; guidelines; pulmonary arterial hypertension; pulmonary arterial hypertension–specific therapies
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