Challenges and Opportunities in Referral to Specialized Care for Interstitial Lung Diseases (ILD): Insights from a Survey of General Practitioners

Introduction: Timely diagnosis and treatment of interstitial lung diseases (ILD) are crucial for slowing disease progression and improving prognosis. General Practitioners (GPs) are essential in recognizing early symptoms and referring to specialised care. The FRAME study aims to understand the ILD patient pathway and ecosystem in primary care, including awareness and management challenges. Methodology: An online survey was conducted involving 200 GPs across five European countries (Belgium, Finland, Portugal, The Netherlands and Sweden), with 40 GPs per country to assess the ILD patient pathway. Data analysis was descriptive. Results and Discussion: Among the respondents, 70% had >10 years of clinical experience (39% >20 years), and the majority were employed in public facilities. ILD awareness among GPs was low (3.9/7, being 1 ‘completely unaware’ and 7 ‘in-depth knowledge’). Depending on the ILD type, 3% to 14% were ‘completely unaware’, despite 80% reported as having seen ILD patients. 40% of GPs reported referring patients within 2 months and 14% after 6 months from onset of symptoms. Half of the GPs believe referral times could be reduced. ILD awareness and time to referral significantly varies across countries, with Portugal showing the highest awareness and Finland the lowest. After ILD diagnosis by specialists, 35% of GPs reported receiving diagnostic confirmation and only 23% communicating with specialists. Despite a high consensus on the importance of the involvement of primary care physicians in detecting worsening symptoms (68%) and enhancing treatment adherence (57%), only 6% of GPs reported being fully involved in ILD follow-up. GPs believe training (63%) and referral algorithms (60%) could reduce referral delays. Conclusion: Low ILD awareness and recognition in primary care impair timely referral to specialised care and diagnosis confirmation. Improved communication between GPs and specialists, along with higher GP involvement in ILD follow-up, specific training, and referral guidelines, could improve patient care.