A new study has assessed the use of antifibrotics among veterans with idiopathic pulmonary fibrosis (IPF) and found their uptake was low and there were disparities in their use. The study, published in Chest, found lower use among women and those diagnosed outside of the Veterans Affairs (VA) healthcare system.
“The prevalence of IPF is high among veterans relative to the general population, with recent data suggesting that military exposures may be associated with a greater risk of IPF,” the authors wrote. “In this study, we used the strength of the Veterans Affairs electronic health record system to examine the real-world adoption and disparities in uptake of antifibrotic medications among veterans with IPF.”
The research team employed VA electronic health records to identify 16,034 patients with IPF between January 1, 2010 and December 21, 2019. Given that 1242 patients had died before antifibrotics became available in 2014, the remaining 14,792 were analyzed.
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Antifibrotics were prescribed to 2576 (17%) patients, with the vast majority (n=1894) receiving them through VA pharmacy benefits and 817 patients obtaining them through Medicare. Those receiving prescriptions were more often male, white, and diagnosed within the VA rather than outside the VA.
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Prescription of antifibrotics was lower for women, black individuals, and those living in rural areas. Even though overall uptake gradually increased over the years, the disparities became even greater over time. The authors note the need for greater systemic use of antifibrotic medications in routine clinical practice with veterans, as well as more attention to overcome the disparities in medication prescription.
The authors suspect the low rate of uptake of antifibrotic therapy in this population could be due to patient and provider factors, costs, and insufficient infrastructure to provide such therapies. They recommend connecting patients who are veterans to expert centers with VA partners to facilitate improved utilization of antifibrotics in this patient group.
Reference
Kaul B, Lee JS, Petersen LA, et al. Disparities in antifibrotic medication utilization among veterans with idiopathic pulmonary fibrosis. Chest. Published online February 18, 2023. doi:10.1016/j.chest.2023.02.027
