Challenges in Idiopathic Pulmonary Fibrosis Management

Objective: The authors aim to evaluate the challenges faced by each stakeholder for Idiopathic pulmonary fibrosis (IPF) management, including the patients, their families/caretakers, Healthcare professionals, and Healthcare policymakers and organizations in Lowmiddle income countries (LMICs) as perceived by 140 pulmonologists from 11 countries who participated in International Respiratory Forum conference 2022 in Ho Chi Minh City, Vietnam. Methodology: A predesigned structured questionnaire was developed about challenges faced by each stakeholder for IPF management. Study participants were randomly divided into four groups, and only one section of the questionnaire was distributed among the participants of each group. Results: It was observed that the physicians greatly supported the psychological well-being of the patients/caregivers and awareness among Healthcare professionals (HCPs) for timely referrals and diagnosis. The caregivers must support the patients to keep their willpower intact. The availability of only those therapies with modest treatment outcomes with no benefits in halting the disease or reducing mortality and the absence of disease-modifying drugs was considered the major challenge faced by Pulmonologists. Patient affordability was considered the key hindering factor affecting High- Resolution Computed Tomography (HRCT) utilization. The development of Interstitial lung disease (ILD) national registries to keep track of disease prevalence and challenges at hand was defined as the urgent healthcare initiatives that need to be taken by the concerned healthcare policymaking authorities. Moreover, the healthcare systems considered comprehensive patient education about disease management and outcomes the most effective self-management strategy to be incorporated and disseminated. Although a small number of patients with ILDs, specifically IPF, receive a prompt and accurate diagnosis, the survey found that protracted delays, frequent misdiagnoses, exposure to expensive and invasive diagnostic procedures, and significant use of healthcare resources mark the more typical diagnostic experience for those with ILD. Conclusion: These findings indicate the requirement for novel diagnostic tools, best clinical practices, and HCPs training to improve the accuracy of diagnoses in ILD patients. Keywords: Idiopathic Pulmonary Fibrosis, Management, Challenges

Significant challenges of COPD Management in developing countries

To explore the challenges faced by each stakeholder for COPD management, including the patients, their family/caretakers, healthcare professionals, and healthcare policymakers & organizations, the authors conducted a survey during the International Respiratory Forum conference 2022 in Ho Chi Minh City, Vietnam. A total of 140 pulmonologists from 11 countries participated in the study. A predesigned structured questionnaire was developed pertaining to questions related to challenges faced by each stakeholder for COPD management in Low-middle income countries (LMIC). Each group received one of the four sections of the questionnaire. It was found that 47% of doctors thought that patients couldn't understand the early symptoms as indicators of a serious illness and were afraid of forming a dependency on long-term drugs. According to 64% of doctors, the most frequent implications experienced by caregivers when caring for COPD patients were the financial burden of lifelong therapies and disappointments from treatment failure brought on by a lack of access to high-quality or specialized healthcare. Of the difficulties experienced by healthcare professionals, 50% said that misusing investigations for diagnosis resulted in delayed or underdiagnoses of COPD. The biggest issue with COPD referrals in developing nations was general practitioners' ignorance of recognizing highrisk patients and the need for their referrals. Approximately 80% of respondents said that a sizeable percentage of annual healthcare spending was consumed by expenses related to exacerbations and repeated ER visits. It is concluded that the questionnaire responses reflect physicians' perceptions and experiences in routine clinical practice. Increased knowledge of COPD diagnosis and treatment recommendations, as well as proactive identification of patients at higher risk of developing COPD due to environmental or lifestyle exposures, will help with prompt, accurate diagnoses and efficient treatments, ultimately improving patient outcomes. Keywords: COPD Management, Challenges, Developing Countries