{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:58:30Z","timestamp":1777521510910,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>Temporal trends of healthcare use in the period before a diagnosis of pulmonary fibrosis are poorly understood. We investigated trends in respiratory symptoms and LR HRU in the 10\u2009years prior to diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed a primary care clinical cohort database (UK OPCRD) and assessed patients aged \u226540\u2009years who had an electronically coded diagnosis of pulmonary fibrosis between 2005 and 2015 and a minimum 2\u2009years of continuous medical records prior to diagnosis. Exclusion criteria consisted of electronic codes for recognized causes of pulmonary fibrosis such as CTD, sarcoidosis or EAA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data for 2223 patients were assessed. Over the 10\u2009years prior to diagnosis of pulmonary fibrosis, there was a progressive increase in HRU across multiple LR\u2010related domains. Five years before diagnosis, 18% of patients had multiple healthcare contacts for LR complaints; this increased to 79% in the year before diagnosis, with 38% of patients having five or more healthcare contacts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There are opportunities to diagnose pulmonary fibrosis at an earlier stage; research into case\u2010finding algorithms and strategies to educate primary care physicians is required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13836","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T08:43:41Z","timestamp":1589186621000},"page":"1274-1282","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Opportunities to diagnose fibrotic lung diseases in routine care: A primary care cohort study"],"prefix":"10.1111","volume":"25","author":[{"given":"Mark G.","family":"Jones","sequence":"first","affiliation":[{"name":"National Institute for Health Research Biomedical Research Centre and Clinical and Experimental Sciences University of Southampton  Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher R.T.","family":"Hillyar","sequence":"additional","affiliation":[{"name":"Barts and the London School of Medicine and Dentistry Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4234-1930","authenticated-orcid":false,"given":"Anjan","family":"Nibber","sequence":"additional","affiliation":[{"name":"Medical Sciences Division University of Oxford  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Chisholm","sequence":"additional","affiliation":[{"name":"Respiratory Effectiveness Group  Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5514-4867","authenticated-orcid":false,"given":"Andrew","family":"Wilson","sequence":"additional","affiliation":[{"name":"Norwich Medical School University of East Anglia  Norwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7192-9149","authenticated-orcid":false,"given":"Toby M.","family":"Maher","sequence":"additional","affiliation":[{"name":"Interstitial Lung Disease Unit Royal Brompton Hospital  London UK"},{"name":"Fibrosis Research Group, National Heart and Lung Institute Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine University of Toronto  Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9728-9992","authenticated-orcid":false,"given":"David","family":"Price","sequence":"additional","affiliation":[{"name":"Centre of Academic Primary Care, Division of Applied Health Sciences University of Aberdeen  Aberdeen UK"},{"name":"Observational and Pragmatic Research Institute  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Walsh","sequence":"additional","affiliation":[{"name":"Fibrosis Research Group, National Heart and Lung Institute Imperial College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8594-1448","authenticated-orcid":false,"given":"Luca","family":"Richeldi","sequence":"additional","affiliation":[{"name":"National Institute for Health Research Biomedical Research Centre and Clinical and Experimental Sciences University of Southampton  Southampton UK"},{"name":"Unit\u00e0 Operativa Complessa di Pneumologia Universit\u00e0 Cattolica del Sacro Cuore, Fondazione Policlinico A. 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