The Interstitial Lung Disease Patient Pathway: from Referral to Diagnosis

Overview

Journal ERJ Open Res

Specialty Pulmonary Medicine

Date 2025 Mar 5

PMID 40040894

Authors

Graham Lough

Rayid Abdulqawi

Gina Amanda

Katerina Antoniou

Arata Azuma

Milind Baldi

Ahmed Bayoumy

Jurgen Behr

Elisabeth Bendstrup

Demosthenes Bouros

Kevin Brown

Nazia Chaudhuri

Tamera J Corte

Vincent Cottin

Bruno Crestani

Kevin R Flaherty

Ian Glaspole

Leticia Kawano-Dourado

Michael P Keane

Martin Kolb

Fernando J Martinez

Maria Molina-Molina

Inigo Ojanguren

Laurence Pearmain

Ganesh Raghu

Paola Rottoli

Stefan C Stanel

Gabriela Tabaj

Carlo Vancheri

Brenda Varela

Bonnie Wang

Athol Wells

Pilar Rivera-Ortega

Affiliations

Soon will be listed here.

Abstract

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.

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