Among 53 surveyed providers, only 47.2% reported high-level knowledge of Alpha-1 antitrypsin deficiency and 43.4% viewed routine testing in COPD patients as unnecessary.
Cross-Sectional (n=53)
No
Significant knowledge gaps and negative attitudes toward routine AATD testing exist among providers, contributing to underdiagnosis despite guideline recommendations.
Abstract Rationale Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed genetic disorder associated with an increased risk of emphysema and COPD. Although guidelines recommend testing all patients with COPD and other at-risk conditions, diagnosis is often delayed by 5-10 years, likely due to limited awareness and uncertainty around testing. Recent survey-based studies from Europe indicate persistent gaps in AATD knowledge and testing practices. This study aims to assess knowledge, attitudes, and practices (KAP) of providers at our institution to identify gaps in awareness and understand how educational background and clinical experience influence testing behavior. Methods Internal medicine, family medicine, and pulmonology providers at UF Health Jacksonville were invited to complete an anonymous survey consisting of a maximum of 23 questions regarding KAP of AATD. Knowledge-based items were categorized for secondary analysis as low-level (“none” or “a little”) or high-level (“average” or “very well”). Results A total of 53 providers completed the survey, including 15 from pulmonology, 32 from internal medicine, and 6 from family medicine. While 49 participants (92.4%) reported high-level knowledge of COPD, only 25 (47.2%) reported high-level knowledge of AATD. Regarding other associated diseases, 49 (92.5%) correctly identified liver disease as associated with AATD, whereas only 14 (26.4%) and 13 (24.5%) recognized panniculitis and vasculitis, respectively. Only 15 participants (28.3%) correctly identified the serum AAT threshold for severe deficiency. Twenty-three respondents (43.4%) believed testing all COPD patients for AATD was unnecessary. Twenty-six respondents (49.1%) reported routine testing for AATD, while 27 (50.9%) did not. Among those who regularly test, only 15 (57.7%) screened all COPD patients. The most common reasons for not testing included not seeing relevant patients (14, 51.9%) and referring them to another specialist (10, 37%). Of those who did not test, 21 (77.8%) reported they do not typically inform patients about AATD as a potential underlying cause for COPD. Eleven (40.7%) viewed testing as too expensive for routine use. Conclusion Our results suggest that knowledge gap about the disease and attitudes toward AAT testing may be contributing to the underdiagnosis of AATD. Despite international guidelines recommendations, 43.4% of all providers view testing all COPD patients as unnecessary, while 40.7% of the providers that do not test believe testing is too expensive for routine use, despite available free commercial testing in the U.S. These gaps remain as major barriers to improving testing and diagnosis rates and must be addressed through focused educational efforts. This abstract is funded by: None
Dincer et al. (Fri,) conducted a cross-sectional in Alpha-1 antitrypsin deficiency (AATD) (n=53). Survey of knowledge, attitudes, and practices was evaluated on Knowledge, attitudes, and practices regarding AATD. Among 53 surveyed providers, only 47.2% reported high-level knowledge of Alpha-1 antitrypsin deficiency and 43.4% viewed routine testing in COPD patients as unnecessary.