Travel distance to subspecialty clinic may impact outcomes in fibrotic interstitial lung disease

Despite having better prognostic indicators at baseline, patients with fibrotic interstitial lung disease (ILD) who lived further away from their subspecialty clinic had a higher risk of death or lung transplant, according to a study.  

Using postal codes, researchers estimated the distance from the home of 1162 patients with fibrotic ILD to their clinic. Patients were classified as near if they lived ≤70km away (n = 856) or far if they lived >70km (n =306).

Younger patients lived further from their clinic. Patients living further from the clinic were more likely to be smokers, have a >6-minute walking distance, and lower composite risk scores when compared to patients that lived near the clinic.

When adjusted for age, sex, and baseline forced vital capacity, patients who lived further from the clinic were at a greater risk of death or lung transplant compared to patients living nearer to the clinic. The finding was largely driven by patients with connective-tissue disease-associated ILD.

“Assuming that disease epidemiology and severity are distributed evenly across geographic regions, these findings raise important questions about equitable access to patient care in large healthcare regions with centralized subspecialty programs,” the authors concluded.

Reference
Johannson KA, Lethebe BC, Assayag D, et al. Travel Distance to Subspecialty Clinic and Outcomes in Patients with Fibrotic Interstitial Lung Disease. Ann Am Thorac Soc. 2021;DOI: 10.1513/AnnalsATS.202102-216OC.