P57 Perspectives on screening and early treatment for pulmonary fibrosis

Résumé fourni par la source

Rationale Pulmonary fibrosis (PF) is a progressive condition characterised by debilitating symptoms and reduced life expectancy. Interstitial lung abnormalities (ILAs) are radiological findings in asymptomatic individuals. Data suggest that a proportion of ILAs will evolve into PF. We aimed to explore stakeholders’ views on screening programmes and early treatment for ILAs. Methods We conducted semi-structured, one-on-one interviews with healthcare professionals (HCPs) experienced in PF management, patients, and first-degree relatives worldwide. We discussed general knowledge of PF and ILAs, screening programs, and early treatment. The interviews were recorded and transcribed verbatim and then analysed using thematic analysis. Results Among HCPs, 25 were respiratory physicians, 8 radiologists, 3 nurses, 2 pharmacists, and 1 GP, with a median of 17 years of experience working with PF. ILAs are acknowledged as incidental findings in asymptomatic patients, with varying approaches to clinical management. A screening program with CT scans is considered feasible, especially for high-risk populations like first-degree relatives, individuals with connective tissue diseases, occupational exposure, and ex-smokers. Active recruitment in primary care and national campaigns is recommended. Disagreements persist regarding clinical trials for ILAs due to insufficient data regarding pathogenesis or progression. Concerns about drug side effects were noted. 25 patients, 5 with familial PF, 5 first-degree relatives, and 4 lung screening program participants reported receiving information mainly from specialists and cited a lack of knowledge in primary care. There is no knowledge about ILAs. A screening program is considered acceptable and encouraged, contingent on a national educational campaign about PF. The lack of awareness is perceived as the primary obstacle. Opinions vary on genetic and biomarker screening, with minor concerns about imaging tests (CXR, CT, MRI). The concept of early treatment receives support, with a focus on initiating an educational campaign as a starting point, along with a low threshold for side effects that do not significantly impact quality of life. Conclusions Initiating an educational campaign to raise awareness about PF is crucial. A CT scan screening program for ILAs could be feasible. The emphasis should be on promoting quality of life and minimising side effects.

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