Abstract Background Idiopathic Pulmonary Fibrosis (IPF) is a progressive lung disease with significantly higher prevalence among U.S. Veterans, particularly those in rural areas. Limited access to specialized care may contribute to underdiagnosis and poorer outcomes in this population. The purpose of this study was to identify barriers to IPF diagnosis, treatment, and referral across rural and urban settings using surveys of VA Physicians. Methods We distributed a national survey to VA primary care providers and pulmonologists using email, and intranet platforms. Responses were anonymous and analyzed in aggregate to ensure privacy. Results This survey revealed key differences in IPF care between urban (N = 85) and rural (N = 12) providers. Urban respondents were more often pulmonologists (38.8%), while half of rural providers were in primary care. Most offered face-to-face care and used telemedicine, though urban providers managed higher respiratory caseloads (50 patients per month; 31.8% vs 0.0%). Both groups reported caring for few IPF patients, but diagnostic delays were more common in rural areas with two-thirds reported a 3-6-month timeline for diagnosis, compared to less than one-three months in urban settings. Access to specialty care was identified as a challenge by rural providers, with 75% located over 25 miles from an ILD specialist. Rural respondents cited distance, transportation, and limited specialist availability as key barriers, while urban providers most often noted long wait times. Collectively, physicians identified 5 key themes to care access for Rural Veterans (1) specialty access, (2) systemic delays, (3) patient adherence, (4) diagnostic limitations, and (5) education. Conclusion This preliminary report highlights disparities in diagnosis and access to care, suggesting a need for improved referral pathways, multidisciplinary care, provider, education and expanded telehealth support in rural settings. Addressing these issues could accelerate diagnosis, boost patient adherence, and improve quality of life for veterans with ILD. Our results are intended to guide the development of targeted interventions that enhance IPF management and improve clinical outcomes for rural Veterans, both within the Veterans Health Administration and in communitybased care settings. This abstract is funded by: Veteran Health Administration/Office of Rural Health
Manjarres et al. (Fri,) studied this question.