Etiological profile and evaluation of DPLD in real-world: the perceived impression of the ILD treating doctors in India

Abstract

Abstract Background The perceived etiologies and the evaluation practice of concerned physicians in the real-world are important for diffuse parenchymal lung disease (DPLD) care. Methods An identified cohort of DPLD treating physicians was given to respond to a set of questions regarding their perception of the relative presence of common etiologies of DPLD in India and also regarding the scope and pattern of evaluation of the condition by them in real-world practice with selective inquiries about the satisfaction and constraints. Results 122 physicians out of 150, mostly (93%) postgraduate and practicing in metropolitan and urban areas (86.07%), participated in the survey. There was the highest abstinence in reply for rare causes of DPLD. As per the highest number/percentage of responses, the perceived etiological distribution for idiopathic pulmonary fibrosis (IPF), non-IPF-ILD (interstitial lung disease), and connective tissue disease-associated ILD was between 11% and 25%, while that of sarcoidosis was 1% to 10 % and chronic hypersensitivity pneumonitis was 26% to 50%. The evaluation habit varied significantly from villages to urban and metropolitan cities. The access to high-resolution computed tomography (HRCT) chest and spirometry was almost universal (98.36%); it dropped to 86.06% and 47.54% for DLCO and multidisciplinary discussions (MDD) (multidisciplinary discussion), respectively. The access to other investigations was variable. The practice of HRCT was universal, but it dropped by 36.30% for spirometry, 67.41% for DLCO, and 62.51% for MDD. The overall satisfaction in evaluation and follow-up was low. Financial and logistic constraints appeared prevalent along with a lack of family support. Conclusion The perceived real-world DPLD practice appears far short of ideal and it needs further investigations to understand the reality to change for betterment.