Dataset Information

Lung transplant referral practice patterns: a survey of cystic fibrosis physicians and general pulmonologists.

ABSTRACT:

Background

Many individuals with cystic fibrosis (CF) die from respiratory failure without referral for lung transplant. Physician practices that may expedite, delay, or preclude referral, are poorly understood.

Methods

Two parallel, web-based surveys focusing on lung transplant referral triggers and barriers, as well as pre-referral evaluation, were emailed to pulmonologists practicing in the New England region. One questionnaire was sent to CF providers (n = 61), and the second to general pulmonary providers practicing at the same institutions (n = 61).

Results

There were 43 (70%) responses to the CF provider survey, and 25 (41%) responses to the general pulmonary ('non-CF') provider survey. Primary reasons for CF providers to refer their patients included: rapidly declining lung function (91%) and a forced expiratory volume in 1 s (FEV₁) below 30% predicted (74%). The greatest barriers to referral for both CF and non-CF providers included active tobacco use (65 and 96%, respectively, would not refer), and active alcohol or other substance use or dependence (63 and 80%). Furthermore, up to 42% of CF providers would potentially delay their referral if triple-combination therapy or other promising new, disease-specific therapy were anticipated. In general, non-CF providers perform a more robust pre-referral medical work-up, while CF providers complete a psychosocial evaluation in higher numbers. Across both groups, communication with lung transplant programs was reported to be inadequate.

Conclusions

Physician-level barriers to timely lung transplant referral exist and need to be addressed. Enhanced communication between lung transplant programs and pulmonary providers may reduce these barriers.

SUBMITTER: Bartley BL

PROVIDER: S-EPMC7055110 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Lung transplant referral practice patterns: a survey of cystic fibrosis physicians and general pulmonologists.

Bartley Bethany L BL Schwartz Carolyn E CE Stark Roland B RB Georgiopoulos Anna M AM Friedman Deborah D Richards Christopher J CJ Dorkin Henry L HL Kinane T Bernard TB Neuringer Isabel P IP Yonker Lael M LM

BMC pulmonary medicine 20200304 1

<h4>Background</h4>Many individuals with cystic fibrosis (CF) die from respiratory failure without referral for lung transplant. Physician practices that may expedite, delay, or preclude referral, are poorly understood.<h4>Methods</h4>Two parallel, web-based surveys focusing on lung transplant referral triggers and barriers, as well as pre-referral evaluation, were emailed to pulmonologists practicing in the New England region. One questionnaire was sent to CF providers (n = 61), and the second ...[more]

PMID: 32131782

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Dataset Information

Lung transplant referral practice patterns: a survey of cystic fibrosis physicians and general pulmonologists.

Background

Methods

Results

Conclusions

Publications

Lung transplant referral practice patterns: a survey of cystic fibrosis physicians and general pulmonologists.

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