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Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: Data from the IPF-PRO registry.

Publication ,  Conference
de Andrade, JA; Kulkarni, T; Neely, ML; Hellkamp, AS; Case, AH; Guntupalli, K; Bender, S; Conoscenti, CS; Snyder, LD; IPF-PRO Registry investigators,
Published in: Respir Med
2021

BACKGROUND: Few data are available on the extent to which clinical practice is aligned with international guidelines for the management of idiopathic pulmonary fibrosis (IPF). We investigated the extent to which management guidelines for IPF have been implemented in the US IPF-PRO Registry and associations between implementation of guidelines and clinical outcomes. METHODS: We assessed the implementation of eight recommendations in clinical practice guidelines within the 6 months after enrollment: visit to a specialized clinic; pulmonary function testing; use of oxygen in patients with resting hypoxemia and exercise-induced hypoxemia; referral for pulmonary rehabilitation; treatment of gastro-esophageal reflux disease; initiation of anti-fibrotic therapy; referral for lung transplant evaluation. An implementation score was calculated as the number of recommendations achieved divided by the number for which the patient was eligible. Associations between implementation score and outcomes were analyzed using logistic regression and Cox proportional hazards models. RESULTS: Among 727 patients, median (Q1, Q3) implementation score was 0.6 (0.5, 0.8). Patients with an implementation score >0.6 had greater disease severity than those with a lower score. Implementation was lowest for referral for pulmonary rehabilitation (19.5%) and lung transplant evaluation (22.3%). In unadjusted models, patients with higher implementation scores had a greater risk of death, death or lung transplant, and hospitalization, but no significant associations were observed in adjusted models. CONCLUSIONS: Management guidelines were more likely to be implemented in patients with IPF with greater disease severity. When adjusted for disease severity, no association was found between implementation of management guidelines and clinical outcomes.

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Published In

Respir Med

DOI

EISSN

1532-3064

Publication Date

2021

Volume

189

Start / End Page

106637

Location

England

Related Subject Headings

  • Severity of Illness Index
  • Respiratory System
  • Respiratory Function Tests
  • Registries
  • Referral and Consultation
  • Oxygen Inhalation Therapy
  • Lung Transplantation
  • Idiopathic Pulmonary Fibrosis
  • Humans
  • Hospitalization
 

Citation

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de Andrade, J. A., Kulkarni, T., Neely, M. L., Hellkamp, A. S., Case, A. H., Guntupalli, K., … IPF-PRO Registry investigators, . (2021). Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: Data from the IPF-PRO registry. In Respir Med (Vol. 189, p. 106637). England. https://doi.org/10.1016/j.rmed.2021.106637
Andrade, Joao A. de, Tejaswini Kulkarni, Megan L. Neely, Anne S. Hellkamp, Amy Hajari Case, Kalpalatha Guntupalli, Shaun Bender, Craig S. Conoscenti, Laurie D. Snyder, and Laurie D. IPF-PRO Registry investigators. “Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: Data from the IPF-PRO registry.” In Respir Med, 189:106637, 2021. https://doi.org/10.1016/j.rmed.2021.106637.
de Andrade JA, Kulkarni T, Neely ML, Hellkamp AS, Case AH, Guntupalli K, et al. Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: Data from the IPF-PRO registry. In: Respir Med. 2021. p. 106637.
de Andrade, Joao A., et al. “Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: Data from the IPF-PRO registry.Respir Med, vol. 189, 2021, p. 106637. Pubmed, doi:10.1016/j.rmed.2021.106637.
de Andrade JA, Kulkarni T, Neely ML, Hellkamp AS, Case AH, Guntupalli K, Bender S, Conoscenti CS, Snyder LD, IPF-PRO Registry investigators. Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: Data from the IPF-PRO registry. Respir Med. 2021. p. 106637.
Journal cover image

Published In

Respir Med

DOI

EISSN

1532-3064

Publication Date

2021

Volume

189

Start / End Page

106637

Location

England

Related Subject Headings

  • Severity of Illness Index
  • Respiratory System
  • Respiratory Function Tests
  • Registries
  • Referral and Consultation
  • Oxygen Inhalation Therapy
  • Lung Transplantation
  • Idiopathic Pulmonary Fibrosis
  • Humans
  • Hospitalization