Social Deprivation and Idiopathic Pulmonary Fibrosis (IPF)

Travel distance to hospital linked to worse disease and outcomes for people with pulmonary fibrosis (PF)
10
May 2024

A new study has found that those with pulmonary fibrosis from the poorest areas had more severe symptoms by the time they saw a hospital doctor and had a poorer survival than those living in wealthier areas.

People with pulmonary fibrosis from the poorest areas had more severe symptoms by the time they saw a hospital doctor and had a poorer survival than those living in wealthier areas, according to new research.

The study, led by the University of East Anglia, also found people living furthest from a hospital pulmonary fibrosis centre also had shorter life expectancy than those living closer. It is estimated that 32,500 people in the UK are living with idiopathic pulmonary fibrosis (IPF).

 

Lead author Professor Andrew Wilson, of UEA’s Norwich Medical School, said:

This is the first time that social deprivation and travelling distance to hospital has been linked to survival for people with pulmonary fibrosis living in the UK.
People planning hospital services for people with pulmonary fibrosis should consider those living far from hospitals and those from poorer backgrounds to make sure these people get the care they need.

 

The researchers used data collected from the British Thoracic Society Interstitial Lung Diseases Registry between 2013 and 2021. For the 2,359 patients included in the study, they calculated a deprivation score, time from initial symptoms to hospital attendance and the linear distance between hospital and home postcodes. 

It found the most deprived patients had a 36% increase in the risk of death compared to the least deprived and when other factors like smoking, gender, age, distance to hospital and time to referral were considered there was still a 39% increase in the risk of death. However, the study found that the effect of social deprivation was mainly confined to the most deprived.

Those living furthest from a respiratory clinic also had worse survival rates compared to those living closest. When looking separately at distance alone, researchers found that there was a 34% increased risk of death for those living furthest away, compared to those living closest, and when allowing for other factors there was still a 29% increase in the risk of death.

 

Bradley Price, Director of Policy and Public Affairs here at Action For Pulmonary Fibrosis, said:

This research highlights an alarming disparity in healthcare equality and access that demands urgent attention. Where you live or your socioeconomic status should not determine how long you live. This is unacceptable.
Change is needed to ensure that everyone has timely access to diagnosis, treatment and care.
A regional integrated approach with more specialist centres, as outlined in OneVoiceILD's integrated care pathway, would go some way in reducing some of the factors outlined in this publication.

 

The results suggest that future screening programmes and policies could be put into place to mitigate the differences in socioeconomic levels, however more research is needed into this, and to see if the ability to access care closer to home improves survival.

The study found that 40% of patients had symptoms for more than two years prior to being seen in specialist clinics. Others diagnosed with PF reported high rates of respiratory symptoms prior to diagnosis, with nearly 80% of patients seeing a GP or being seen in a primary care setting in the year prior to referral.

The researchers say this suggests there is a need to advocate for greater awareness of IPF in primary care and care closer to home may result in greater survival.

The full study article, ‘Assessment of the impact of social deprivation, distance to hospital and time to diagnosis on survival in Idiopathic Pulmonary Fibrosis’ is published in RespiratoryMedicine and can be accessed at this link.