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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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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.

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

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