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首页> 外文期刊>European Clinical Respiratory Journal >Organisation of diagnosis and treatment of idiopathic pulmonary fibrosis and other interstitial lung diseases in the Nordic countries
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Organisation of diagnosis and treatment of idiopathic pulmonary fibrosis and other interstitial lung diseases in the Nordic countries

机译：在北欧国家组织特发性肺纤维化和其他间质性肺疾病的诊断和治疗

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IntroductionDifferences in the organisation of idiopathic pulmonary fibrosis (IPF) and interstitial lung diseases (ILDs) in the Nordic countries are not well described. Diagnostic setups, treatment modalities and follow-up plans may vary due to national, cultural and epidemiological features. The aim of the present study was to describe the different organisation of diagnostics and treatment of IPF and ILD in the Nordic countries.MethodsAll university and regional hospitals with respiratory physicians were invited to respond to a questionnaire collecting data on the number of physicians, nurses, patients with ILD/IPF, the presence of and adherence to disease-specific national and international guidelines, diagnosis and treatment including ILD-specific palliation and rehabilitation programmes.ResultsTwenty-four university and 22 regional hospitals returned the questionnaire. ILD and IPF incidence varied between 1.4 and 20/100,000 and 0.4 and 10/100,000, respectively. Denmark and Estonia have official national plans for the organisation of ILD. The majority of patients are managed at the university hospitals. The regional hospitals each manage 46 (5–200) patients with ILD and 10 (0–20) patients with IPF. There are from one to four ILD centres in each country with a median of two ILD specialists employed. Specialised ILD nurses are present in nine hospitals. None of the Nordic countries have national guidelines made by health authorities. The respiratory societies in Sweden, Norway and Denmark have developed national guidelines. All hospitals except two use the ATS/ERS/JRS/ALAT IPF guidelines from 2011. The limited number of ILD specialists, ILD-specialised radiologists and pathologists and the low volume of ILD centres were perceived as bottlenecks for implementation of guidelines. Twenty of the 24 university hospitals have multidisciplinary conferences (MDCs). Pulmonologists and radiologists take part in all MDCs while pathologists only participate at 17 hospitals. Prescription of pirfenidone is performed by all university hospitals except in Estonia. Triple therapy with steroid, azathioprine and N -acetylcysteine is not used. No hospitals have specific palliation programmes for patients with ILD/IPF, but 36 hospitals have the possibility of referring patients for palliative care, mostly based on existing oncology palliative care teams; seven hospitals have rehabilitation programmes for ILD.ConclusionThere are obvious differences between the organisations of ILD patients in the Nordic countries. We call for national plans that consider the challenge of cultural and geographical differences and suggest the establishment of national reference centres and satellite collaborative hospitals to enable dev.
机译：简介北欧国家在特发性肺纤维化（IPF）和间质性肺疾病（ILD）的组织上的差异没有得到很好的描述。诊断设置，治疗方式和后续计划可能因国家，文化和流行病学特征而异。本研究的目的是描述北欧国家IPF和ILD的诊断和治疗的不同组织。方法邀请所有有呼吸道医师的大学和地区医院对收集医生，护士，患有ILD / IPF的患者，是否存在和遵守特定疾病的国家和国际准则，诊断和治疗方法，包括ILD特定的缓解和康复计划。 ILD和IPF的发生率分别在1.4和20 / 100,000之间以及0.4和10 / 100,000之间变化。丹麦和爱沙尼亚对国际劳工组织的组织有正式的国家计划。大多数患者在大学医院接受治疗。区域医院分别管理46（5–200）名ILD患者和10（0–20）名IPF患者。每个国家有1至4个ILD中心，平均聘用了2名ILD专家。九家医院设有专门的ILD护士。北欧国家都没有卫生当局制定的国家指南。瑞典，挪威和丹麦的呼吸学会已经制定了国家指南。从2011年开始，除两家医院外，所有医院都使用ATS / ERS ​​/ JRS / ALAT IPF指南。ILD专家的数量有限，ILD专门的放射线医生和病理学家以及ILD中心数量少被视为实施指南的瓶颈。 24家大学医院中的20家拥有多学科会议（MDC）。肺科医生和放射科医生参加了所有MDC，而病理学家仅参加了17家医院。除爱沙尼亚外，所有大学医院都对吡非尼酮开处方。没有使用类固醇，硫唑嘌呤和N-乙酰半胱氨酸的三联疗法。没有医院为ILD / IPF患者提供具体的缓解方案，但有36家医院有可能将患者转诊为姑息治疗，而这主要是基于现有的肿瘤姑息治疗小组进行的;七家医院都有针对ILD的康复计划。结论在北欧国家，ILD患者组织之间存在明显差异。我们呼吁制定考虑文化和地理差异挑战的国家计划，并建议建立国家参考中心和卫星协作医院以帮助开发人员。

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