Global survey of physician testing practices for nontuberculous mycobacteria
Background Certain patients are at greater risk of developing nontuberculous mycobacterial pulmonary disease (NTM-PD), including those with lung conditions such as bronchiectasis. Testing for nontuberculous mycobacteria (NTM) in patients at risk is necessary to identify NTM-PD and start appropriate...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-05-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/3/00737-2022.full |
| _version_ | 1797689386286972928 |
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| author | Michael R. Loebinger Roald van der Laan Marko Obradovic Jakko van Ingen |
| author_facet | Michael R. Loebinger Roald van der Laan Marko Obradovic Jakko van Ingen |
| author_sort | Michael R. Loebinger |
| collection | DOAJ |
| description | Background
Certain patients are at greater risk of developing nontuberculous mycobacterial pulmonary disease (NTM-PD), including those with lung conditions such as bronchiectasis. Testing for nontuberculous mycobacteria (NTM) in patients at risk is necessary to identify NTM-PD and start appropriate management. The aim of this survey was to evaluate current testing practices for NTM and identify testing triggers.
Methods
Physicians (n=455) who see at least one patient with NTM-PD in a typical 12-month period and test for NTM as part of practice from Europe, USA, Canada, Australia, New Zealand and Japan participated in a 10-min anonymised survey on NTM testing practices.
Results
Bronchiectasis, COPD and use of immunosuppressants were the factors most likely to prompt testing among physicians in this survey (90%, 64% and 64%, respectively), with radiological findings the most common reason leading to considering NTM testing in patients with bronchiectasis and COPD (62% and 74%, respectively). Macrolide monotherapy in patients with bronchiectasis and inhaled corticosteroid use in patients with COPD were not important triggers for testing (15% and 9% of physicians, respectively). Persistent cough and weight loss triggered testing in >75% of physicians. Testing triggers were markedly different for physicians in Japan, with cystic fibrosis prompting testing in fewer physicians compared with other regions.
Conclusions
Testing for NTM is influenced by underlying disease, clinical symptoms or radiological changes, but clinical practice varies considerably. Adherence to guideline recommendations for NTM testing is limited in certain patient subgroups and varies across regions. Clear recommendations on NTM testing are needed. |
| first_indexed | 2024-03-12T01:44:58Z |
| format | Article |
| id | doaj.art-f8e7ad99c174487b88858ce415ef2025 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-12T01:44:58Z |
| publishDate | 2023-05-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-f8e7ad99c174487b88858ce415ef20252023-09-09T13:53:53ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-05-019310.1183/23120541.00737-202200737-2022Global survey of physician testing practices for nontuberculous mycobacteriaMichael R. Loebinger0Roald van der Laan1Marko Obradovic2Jakko van Ingen3 Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK Insmed BV, Utrecht, The Netherlands Insmed Germany GmbH, Frankfurt am Main, Germany Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands Background Certain patients are at greater risk of developing nontuberculous mycobacterial pulmonary disease (NTM-PD), including those with lung conditions such as bronchiectasis. Testing for nontuberculous mycobacteria (NTM) in patients at risk is necessary to identify NTM-PD and start appropriate management. The aim of this survey was to evaluate current testing practices for NTM and identify testing triggers. Methods Physicians (n=455) who see at least one patient with NTM-PD in a typical 12-month period and test for NTM as part of practice from Europe, USA, Canada, Australia, New Zealand and Japan participated in a 10-min anonymised survey on NTM testing practices. Results Bronchiectasis, COPD and use of immunosuppressants were the factors most likely to prompt testing among physicians in this survey (90%, 64% and 64%, respectively), with radiological findings the most common reason leading to considering NTM testing in patients with bronchiectasis and COPD (62% and 74%, respectively). Macrolide monotherapy in patients with bronchiectasis and inhaled corticosteroid use in patients with COPD were not important triggers for testing (15% and 9% of physicians, respectively). Persistent cough and weight loss triggered testing in >75% of physicians. Testing triggers were markedly different for physicians in Japan, with cystic fibrosis prompting testing in fewer physicians compared with other regions. Conclusions Testing for NTM is influenced by underlying disease, clinical symptoms or radiological changes, but clinical practice varies considerably. Adherence to guideline recommendations for NTM testing is limited in certain patient subgroups and varies across regions. Clear recommendations on NTM testing are needed.http://openres.ersjournals.com/content/9/3/00737-2022.full |
| spellingShingle | Michael R. Loebinger Roald van der Laan Marko Obradovic Jakko van Ingen Global survey of physician testing practices for nontuberculous mycobacteria ERJ Open Research |
| title | Global survey of physician testing practices for nontuberculous mycobacteria |
| title_full | Global survey of physician testing practices for nontuberculous mycobacteria |
| title_fullStr | Global survey of physician testing practices for nontuberculous mycobacteria |
| title_full_unstemmed | Global survey of physician testing practices for nontuberculous mycobacteria |
| title_short | Global survey of physician testing practices for nontuberculous mycobacteria |
| title_sort | global survey of physician testing practices for nontuberculous mycobacteria |
| url | http://openres.ersjournals.com/content/9/3/00737-2022.full |
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