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Alpha1-antitrypsin deficiency - diagnostic testing and disease awareness in Germany and Italy.
- Source :
-
Respiratory medicine [Respir Med] 2013 Sep; Vol. 107 (9), pp. 1400-8. Date of Electronic Publication: 2013 Jun 17. - Publication Year :
- 2013
-
Abstract
- Background: Alpha1-antitrypsin (AAT) deficiency, although largely under-diagnosed, is the underlying cause of approximately 1% of COPD cases. Lack of awareness leads to long delays in diagnostic testing. Subsequently, lifestyle and treatment choices with potentially positive effects on prognosis may be postponed.<br />Methods: Data on the testing and diagnostic practices for AAT deficiency were derived from the University of Pavia, Italy, and the University of Marburg, Germany. In addition, a survey of physicians was undertaken to explore their awareness and attitudes toward AAT deficiency.<br />Results: In Pavia and Marburg, 125 and 729 patients, respectively, were identified with severe AAT deficiency between July 2006 and June 2011. The median time interval between the onset of symptoms and diagnosis was 6 years (interquartile range [IQR], 11; range, 0-40) and 7 years (IQR, 13; range, 0-73), respectively. Augmentation therapy was initiated almost immediately in Germany while treatment was delayed by 3 months in Italy (IQR, 5.25; range, 1-118). Survey data (Italy, n = 181; Germany, n = 180) revealed that pulmonologists had greater knowledge of AAT deficiency than internists and general practitioners, however, overall, only 18-25% of physicians tested all COPD patients. One-third of the respondents stated that they "sometimes" offered augmentation therapy to patients diagnosed with AAT deficiency.<br />Conclusions: Major obstacles to AAT deficiency testing are physicians' attitudes and lack of understanding of the condition. A greater adherence to the guidelines that recommend diagnostic testing of all COPD patients, coupled with simpler testing protocols, may decrease delays and positively impact patient outcomes.<br /> (Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Subjects :
- Awareness
Clinical Competence standards
Communication
Delayed Diagnosis
Germany
Humans
Interprofessional Relations
Italy
Physician-Patient Relations
Pulmonary Medicine standards
Registries
Time-to-Treatment
alpha 1-Antitrypsin Deficiency psychology
alpha 1-Antitrypsin Deficiency therapy
Attitude of Health Personnel
Attitude to Health
alpha 1-Antitrypsin Deficiency diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1532-3064
- Volume :
- 107
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Respiratory medicine
- Publication Type :
- Academic Journal
- Accession number :
- 23786890
- Full Text :
- https://doi.org/10.1016/j.rmed.2013.04.023