{
  "abstract": "Introduction There is growing evidence to support the use of interventions beyond inhaled medications in COPD. Clinician attitudes and access to these therapies are crucial to informing COPD care pathways and the development of personalised care.Aims We sought to explore current attitudes, practices, future directions and challenges in the management of moderate-severe COPD in the Republic of Ireland (ROI).Methods We created a custom online survey comprising 38 questions, divided into 6 domains: responder demographics, pulmonary rehabilitation (PR), Long-term Non-invasive Ventilation (LTNIV), lung volume reduction (LVR), biologics therapies and lung transplantation. This was disseminated by email and text messaging to respiratory consultants in the ROI through the Irish Thoracic Society consultant contact list.Results 37 responses were returned (24.5% response rate) between 4th December 2024 and 13th February 2025, with 36 eligible for inclusion. Completion rate was 97.2% (35/36). Only a minority reported sufficient access to PR (30%), or a dedicated COPD multidisciplinary team (MDT) (31%). 34% infrequently or never consider LTNIV despite 78% perceiving the quality of evidence on its benefit in reducing hospitalisations to be high or moderate. 59% infrequently or never consider LVR despite perceiving it to be moderately or highly beneficial towards improving exercise capacity (92%) and QoL (88%). 79% infrequently refer patients with COPD for lung transplant assessment. 31% were unsure about the emerging evidence for biologics in COPD. Perceived challenges to future integration of biologics into COPD care in ROI include the current absence of national drug reimbursement agreements, lack of dedicated COPD MDTs, and administrative burden.Abstract P1 Table 1Perceived challenges in integrating biologic therapies into care pathways for patients with COPDConclusion Our study provides insights into the current landscape of COPD management in the ROI. While significant progresses have been made in the diagnosis and management of COPD, access to essential services, such as pulmonary rehabilitation and a dedicated COPD MDT, remain suboptimal. There exists significant heterogeneity in the attitudes towards LTNIV and LVR, and uncertainty in relation to the role of biologics in COPD. Infrastructural limitations and lack of local guidelines are amongst the various issues that need to be addressed in order to optimise COPD care in the ROI.",
  "authors": [
    {
      "affiliations": [
        "Department of Respiratory Medicine, St Vincent, Dublin, Ireland"
      ],
      "name": "J Lim"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, St Vincent, Dublin, Ireland",
        "School of Medicine, University College Dublin, Dublin, Ireland"
      ],
      "name": "HO O’Brien"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, St Vincent, Dublin, Ireland"
      ],
      "name": "JM McCarthy"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, St Vincent, Dublin, Ireland",
        "School of Medicine, University College Dublin, Dublin, Ireland"
      ],
      "name": "CM McCarthy"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, St Vincent, Dublin, Ireland",
        "School of Medicine, University College Dublin, Dublin, Ireland"
      ],
      "name": "A Franciosi"
    }
  ],
  "title": "P1 Current practices, perceptions and future challenges in COPD management",
  "uid": "88e2876c-77b5-545c-9f05-43157e3ed361"
}