M13 From interstitial lung disease (ILD) multidisciplinary team meeting (MDT) to anti-fibrotic medication – review of regional MDT referrals
| Autor: | Ian Forrest, S Wiscombe, Claire Donaldson, L Langlands, CJ Murphy, AJ Simpson |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Medication review
medicine.medical_specialty business.industry Interstitial lung disease Nice Pirfenidone medicine.disease FEV1/FVC ratio Idiopathic pulmonary fibrosis chemistry.chemical_compound chemistry Internal medicine medicine Nintedanib Differential diagnosis business computer computer.programming_language medicine.drug |
| Zdroj: | Real world studies with antifibrotics in IPF. |
| DOI: | 10.1136/thorax-2019-btsabstracts2019.421 |
| Popis: | Introduction NICE guidelines recommend diagnosis of idiopathic pulmonary fibrosis (IPF) only with the consensus of an MDT.1 Patients with (suspected) ILD in the North East are referred from 12 regional trusts to the Newcastle Interstitial Lung Diseases Service (NILDS) MDT for discussion. NILDS is the regional prescriber for anti-fibrotic medications (AFM) Nintedanib and Pirfenidone. Aims To review the referrals made to the NILDS MDT, establish the number of patients diagnosed with IPF and those prescribed AFM at first follow up. Method Retrospective review of all NILDS MDT patient lists over a twelve month period (January – December 2016) and review of MDT and subsequent clinic follow-up outcomes. Results 659 patients were referred to the MDT. In 43 (6.5%) cases no records or minimal information could be found, leaving 616 patients for analysis. New patients referred into the NILDS who were diagnosed with IPF at the MDT (n=118) were seen within 9.1 weeks of the MDT taking place (range: -1 day – 34.7 weeks). In total (NILDS and non-NILDS patients), 199 (32.3%) patients were diagnosed with IPF or included IPF in the differential diagnosis. 72/199 (36.2%) patients were started on AFM at the first outpatient appointment following the MDT – 48/72 (66.7%) on Nintedanib and 24/72 (33.3%) on Pirfenidone. 127/199 (63.8%) patients did not receive AFM. Reasons for not prescribing AFM (see table 1) were multiple in nature for 8 patients. This review did not include patients receiving AFM at later stages in their follow-up period or those discussed at MDTs prior to 2016. Conclusion Over a twelve-month period, one-third of referrals were diagnosed with IPF by the NILDS MDT consensus. One-third of patients with IPF were started on AFM. A disparity in the choice of AFM is evident with the majority of patients receiving Nintedanib for treatment of their IPF. The majority of patients are above the therapeutic threshold at the time of MDT review. Monitoring FVC at regular follow-up is therefore vital to ensure treatment initiation at earliest opportunity. |
| Databáze: | OpenAIRE |
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