Abstract
Aims: To determine Italian Pulmonologist's attitudes and behaviour towards diagnostic and therapeutical choices in competent IPF-ARF patients.
Methods: A web-site survey (30-items questionnaire) was sent to all the members of the Study Groups of Respiratory Intensive Care and Diffuse Lung Diseases of Italian Association of Italian Pulmonologists (January-March 2009).
Results: 248/370 (67%) physicians responded to the questionnaire (>60%:over-fifties, male, Catholics).
About 75% of respondents agreed on having anticipated directives and on eventually communicating bad news about IPF-ARF.
>75% of respondents answered that any diagnostic (BAL and/or TBB) and therapeutical choices (drugs,ventilation,palliative care) should be discussed with the patients and relatives. However, almost 50% of respondents reported to start ventilation and palliative care only in <25% of cases.
BAL under NIV was recommended to eventually find the cause of ARF by half of respondents, while 77% reported to perform BAL and/or TBB in <25% of cases.
More responders stated that NIV was not likely to improve survival (76.7% vs 10.0%) and to facilitate the communication with the relatives (50.7% vs 19.4%). 43.5% of the physicians did not agree on the concept of using NIV to reduce dyspnea and 40% on its use to gain time for end-of-life decisions. >60% of the respondents considered to perform NIV and intubation when a reversible ARF cause is supposed.
About 60% of the respondents used NIV and palliation in <25% of cases, while >90% of them intubated patients in <25% of cases.
Conclusions: A discrepancy between attitudes and behaviour of Italian Pulmonologists emerged towards IPF-ARF issues.
- © 2011 ERS