PURPOSE: α1-Antrypsin Deficiency (AATD) is an under-recognized and under-diagnosed condition.There are concerns that automatic testing of referred patients to the PFT lab by Respiratory Therapists (RT) may not be agreeable to the referring physicians.
METHODS: A questionnaire on personal practice habits of ordering laboratory tests was provided to physicians at Cleveland Clinic in Weston Florida.
RESULTS: Forty-one Physicans responded (45% response): Internists / Family Physicians/ Geriatrics (29%) and specialists (71%). Ninety three percent of the physicians felt very positive about their patients being tested automatically at the PFT lab , while 4.9% remained neutral and 2.4% were against it. Ninety percent of physicians felt very positive about their patients participating in any genetic screening that is approved, 4.9 remained neutral and 4.9 were against this idea. 61% of the physicians indicated that they were not familiar with protections offered by GINA (Genetic Information Nondiscrimination Act). Majority of physicians (99%) wanted to find out more information regarding GINA. When asked despite ATS/ERS recommendations why they don’t test, 36.4% physicians claimed not being aware of it , 27.2 % thought a diagnosis will not change the treatment, 20.5% said it is difficult to select high yield patients to test, and 15.2% thought AATD is a rare disease not worth testing. Finally, when asked what physicians thought can encourage testing 56.9% said physicians need more education about the benefits of AATD and hazards of delayed diagnosis, 23.5 % agreed that AATD testing should be in the checklist of test ordered, 15.7% said RT and other health care professionals should offer the test to qualified patients, and lastly 3.92 % stated all of the above.
CONCLUSION: Most physicians agree to their patients being tested for AATD automatically when sent for pulmonary function testing or pulmonary rehabilitation. There is a great need for further understanding of GINA and AATD disease state.
CLINICAL IMPLICATIONS: PFT labs should enjoy the support of a great majority of their referring physicians when they institute automatic PFT based testing for AATD.
DISCLOSURE: Franck Rahaghi, Grant monies (from sources other than industry) Grant form Betty and Stu Hamilton fund for Pulmonary Reseacrh; Grant monies (from industry related sources) Research Grant, Baxter Inc. and CSL Behring; Shareholder None; Employee None; Consultant fee, speaker bureau, advisory committee, etc. Consultant and speaker for CSL Behring and Baxter Inc.; No Product/Research Disclosure Information