title: Adherence to guidelines in idiopathic pulmonary fibrosis: a follow-up national survey.
abstract: A new survey coordinated by the French expert centres for rare pulmonary diseases investigated French pulmonologists' diagnostic and therapeutic practice for idiopathic pulmonary fibrosis (IPF) and explored changes since a previous survey in 2011-2012. From May 16 to August 30, 2014, 524 pulmonologists were contacted. Those following at least one patient with IPF were invited to complete a questionnaire administered by telephone or e-mail. 166 (31.7%) pulmonologists, 161 (97%) of whom had participated to the first survey, completed the questionnaire. Of those, 46% and 52%, respectively, discussed the cases with radiologists and pathologists. Out of 144 pulmonologists practicing outside of expert centres, 80% indicated referring patients to those centres. The 2013 French practical guidelines for IPF were known by 92% of pulmonologists involved in IPF, 96% of whom considered them appropriate for practice. The multidisciplinary discussion form for IPF diagnosis was known by 74% and considered appropriate by 94%. Diagnosis and management resulted from multidisciplinary discussion in 50% of the cases. About 58% of patients were diagnosed with "mild to moderate IPF" as defined by forced vital capacity ≥50% of the predicted value and diffusing capacity for carbon monoxide ≥35% of predicted. At the time of the survey, 31% of physicians were using pirfenidone to treat patients with "mild-to-moderately severe IPF" and 30% generally prescribed no treatment. Substantial improvement has occurred since the 2011-2012 survey with regard to knowledge of guidelines and proper management of IPF. Early diagnosis still needs to be improved through the network of expert centres.
authors.affiliation: National Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
authors.affiliation: University Hospital, Caen, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bergot
authors.affiliation: University Hospital, Montpellier, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Bourdin
authors.affiliation: Tenon University Hospital, Paris, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cadranel
authors.affiliation: University Hospital, Dijon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Camus
authors.affiliation: Bichat University Hospital, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Crestani
authors.affiliation: University Hospital, Besançon, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Dalphin
authors.affiliation: University Hospital, Rennes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Delaval
authors.affiliation: University Hospital, Bordeaux, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Dromer
authors.affiliation: European Hospital Georges Pompidou, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Israel-Biet
authors.affiliation: University Hospital Civil, Strasbourg, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Kessler
authors.affiliation: University Hospital, Tours, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Marchand-Adam
authors.affiliation: University Hospital, Nice, France.
authors.forename: Charles Hugo
authors.initials: CH
authors.lastname: Marquette
authors.affiliation: University Hospital, Toulouse, France.
authors.forename: Grégoire
authors.initials: G
authors.lastname: Prévot
authors.affiliation: University Hospital, Marseille, France.
authors.forename: Martine
authors.initials: M
authors.lastname: Reynaud-Gaubert
authors.affiliation: AP-HP, Avicenne University Hospital, Bobigny, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Valeyre
authors.affiliation: University Hospital, Lille, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Wallaert
authors.affiliation: Opened Mind Health, Lille, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Bouquillon
authors.affiliation: National Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Claude Bernard Lyon 1 University, Lyon, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cordier