Perception of the role of Telemedicine in Interstitial Lung Diseases: ­Findings from Società Italiana di Pneumologia/ Italian Respiratory ­Society (SIP-IRS) survey

Perception of the role of Telemedicine in Interstitial Lung Diseases: ­Findings from Società Italiana di Pneumologia/ Italian Respiratory ­Society (SIP-IRS) survey

Authors

  • Giorgio Monteleone Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy
  • Gioele Castelli Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova
  • Giovanni Franco University of Milano Bicocca, School of Medicine and Surgery, UOC Pneumologia, Fondazione IRCCS San Gerardo Dei Tintori, 20900, Monza, Italy
  • Marialuisa Bocchino UOC Pneumotisiology, Department of Clinical Medicine and Surgery, University Federico II, Naples
  • Luigi Carroccio Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy
  • Francesca Lalla Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy
  • Francesca Cefaloni Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy
  • Silvia Deidda Pulmonology Unit, Binaghi Hospital, Cagliari, Italy
  • Davide Chimera Azienda Ospedaliera Universitaria Pisana
  • Rosangela di Liberti Dipartimento Universitario di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro” (PROMISE), Division of Respiratory Medicine, “Paolo Giaccone” University Hospital, University of Palermo; Palermo; Italy
  • Giuseppe Muscato Regional Referral Centre for Rare Lung Disease, Department of Clinical and Experimental Medicine, University Hospital "Policlinico G.Rodolico-San Marco", University of Catania, Catania, Italy
  • Jacopo Simonetti Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy
  • Bruno Iovene Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  • Francesco Varone Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  • Tommaso Pianigiani Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
  • Laura Bergantini Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
  • Miriana d'Alessandro Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
  • Giacomo Sgalla Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  • Luca Richeldi Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  • Elena Bargagli Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
  • Barbara Ruaro Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
  • Paolo Cameli Respiratory Diseases Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy

Keywords:

telemedicine; interstitial lung diseases; medical settings; ILD management

Abstract

Background: Telemedicine (TM) is increasingly recognised as a valuable tool in the management of interstitial lung diseases (ILDs). Despite its potential, its integration and application still remain limited. Our work aimed to assess pulmonologists’ (physicians and trainees) perception regarding the use of TM in ILDs management.
Methods: This national survey was created and distributed to all pulmonologists, both physicians and trainees, affiliated with Società Italiana di Pneumologia/Italian Respiratory Society (SIP/IRS). Responses were collected anonymously and analysed by using descriptive statistical analysis and the chi-square test. 
Results: Among 2,906 invited participants, 44 completed the survey. While 95.5% of respondents considered TM useful in ILDs monitoring, only 36% reported its use in clinical practice. Current barriers included reduced availability of TM services (64%) and limited knowledge of TM software (56.8%). Moreover, the majority of participants referred a supportive but not substitutive role of TM in-person consultations, especially in monitoring and patient education. A significant proportion of repliers (over 50%) claimed that it may reduce waiting lists and enhance patient satisfaction (63.6%). However, concerns regarding data security and absence of standardised protocols were also reported. 
Conclusions: TM is positively perceived by both physicians and trainees’ pulmonologist for ILDs follow-up and educational purposes in ILD management. Nevertheless, its integration and application are still hindered by some concerns such as limited infrastructure and digital literacy as well as lack of standardisation of reimbursement protocols and evolving regulatory frameworks. Broader integration of TM will require to address these challenges through investments in technology, structured protocols, and training initiatives. 

Author Biographies

Gioele Castelli, Respiratory Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, 35128 Padova

Members of ILDs Study Group SIP/IRS

Giovanni Franco, University of Milano Bicocca, School of Medicine and Surgery, UOC Pneumologia, Fondazione IRCCS San Gerardo Dei Tintori, 20900, Monza, Italy

Members of ILDs Study Group SIP/IRS

Luigi Carroccio, Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy

Member of ILDs Study Group SIP/IRS

Francesca Lalla, Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy

Member of ILDs Study Group SIP/IRS

Francesca Cefaloni, Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy

Member of ILDs Study Group SIP/IRS

Silvia Deidda, Pulmonology Unit, Binaghi Hospital, Cagliari, Italy

Member of ILDs Study Group SIP/IRS

Davide Chimera, Azienda Ospedaliera Universitaria Pisana

Member of ILDs Study Group SIP/IRS

Rosangela di Liberti , Dipartimento Universitario di Promozione Della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D'Alessandro” (PROMISE), Division of Respiratory Medicine, “Paolo Giaccone” University Hospital, University of Palermo; Palermo; Italy

Member of ILDs Study Group SIP/IRS

References

1. Chaet D, Clearfield R, Sabin JE, Skimming K, Council on Ethical and Judicial Affairs American Medical Association. Ethical practice in telehealth and telemedicine. J Gen Intern Med 2017;32:1136–40.

2. Walsh SLF, Calandriello L, Silva M, Sverzellati N. Deep learning for classifying fibrotic lung disease on high-resolution computed tomography: a case-cohort study. Lancet Respir Med 2018;6:837–45.

3. Richeldi L, Collard HR, Jones MG. Idiopathic pulmonary fibrosis. Lancet 2017;389:1941–52.

4. Raghu G, Remy-Jardin M, Richeldi L, Thomson CC, Inoue Y, Johkoh T, et al. Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2022;205:e18–47.

5. Rajan SK, Cottin V, Dhar R, Danoff S, Flaherty KR, Brown KK, et al. Progressive pulmonary fibrosis: an expert group consensus statement. Eur Respir J 2023;61:2103187.

6. Althobiani MA, Evans RA, Alqahtani JS, Aldhahir AM, Russell AM, Hurst JR, et al. Home monitoring of physiology and symptoms to detect interstitial lung disease exacerbations and progression: a systematic review. ERJ Open Res 2021;7:00441–2021.

7. Wijsenbeek MS, Moor CC, Johannson KA, Jackson PD, Khor YH, Kondoh Y, et al. Home monitoring in interstitial lung diseases. Lancet Respir Med 2023;11:97–110.

8. Monteleone G, Terzulli G, Cefaloni F, Bonini M, Richeldi L. The impact of telemedicine during severe acute respiratory syndrome coronavirus 2 pandemic and future perspectives: a systematic review. Respiration 2023;102:879–90.

9. Bellini V, Valente M, Gaddi AV, Pelosi P, Bignami E. Artificial intelligence and telemedicine in anesthesia: potential and problems. Minerva Anestesiol 2022;88. Available from: https://www.minervamedica.it/index2.php?show=R02Y2022N09A0729

10. Kidholm K, Jensen LK, Johansson M, Montori VM. Telemedicine and the assessment of clinician time: a scoping review. Int J Technol Assess Health Care 2024;40:e3.

11. Panagopoulos C, Malli F, Menychtas A, Smyrli EP, Georgountzou A, Daniil Z, et al. Utilizing a homecare platform for remote monitoring of patients with idiopathic pulmonary fibrosis. In: Vlamos P, editor. GeNeDis 2016. Cham: Springer International Publishing; 2017. p. 177–87. (Adv Exp Med Biol; vol. 989). Available from: http://link.springer.com/10.1007/978-3-319-57348-9_15

12. Moor CC, Mostard RLM, Grutters JC, Bresser P, Aerts JGJV, Chavannes NH, et al. Home monitoring in patients with idiopathic pulmonary fibrosis: a randomized controlled trial. Am J Respir Crit Care Med 2020;202:393–401.

13. Bekelman DB, Feser W, Morgan B, Welsh CH, Parsons EC, Paden G, et al. Nurse and social worker palliative telecare team and quality of life in patients with COPD, heart failure, or interstitial lung disease: the ADAPT randomized clinical trial. JAMA 2024;331:212.

14. Eze ND, Mateus C, Cravo Oliveira Hashiguchi T. Telemedicine in the OECD: an umbrella review of clinical and cost-effectiveness, patient experience and implementation. PLoS One 2020;15:e0237585.

15. Grant-Orser A, Adderley NA, Stuart K, Fell CD, Johannson KA. Patient and physician assessments of clinical status. Chest Pulmonol 2023;1:100003.

16. Buvik A, Bergmo TS, Bugge E, Smaabrekke A, Wilsgaard T, Olsen JA. Cost-effectiveness of telemedicine in remote orthopedic consultations: randomized controlled trial. J Med Internet Res 2019;21:e11330.

17. De Jong MJ, Boonen A, Van Der Meulen-de Jong AE, Romberg-Camps MJ, Van Bodegraven AA, Mahmmod N, et al. Cost-effectiveness of telemedicine-directed specialized vs standard care for patients with inflammatory bowel diseases in a randomized trial. Clin Gastroenterol Hepatol 2020;18:1744–52.

18. Padilla Conde T, Robinson L, Vora P, Ware SL, Stromberg A, Bastos De Carvalho A. Effectiveness of telemedicine diabetic retinopathy screening in the USA: a protocol for systematic review and meta-analysis. Syst Rev 2023;12:48.

19. Kelly JT, Law L, De Guzman KR, Hickman IJ, Mayr HL, Campbell KL, et al. Cost-effectiveness of telehealth-delivered nutrition interventions: a systematic review of randomized controlled trials. Nutr Rev 2023;81:1599–611.

20. Cui S, Sedney CL, Daffner SD, Large MJ, Davis SK, Crossley L, et al. Effects of telemedicine triage on efficiency and cost-effectiveness in spinal care. Spine J 2021;21:779–84.

21. Pfeil JN, Rados DV, Roman R, Katz N, Nunes LN, Vigo Á, et al. A telemedicine strategy to reduce waiting lists and time to specialist care: a retrospective cohort study. J Telemed Telecare 2023;29:10–7.

22. Glenn LM, Jackson D, Barton C, Lan D, Fuhrmeister L, Symons K, et al. Usability of a smartphone application for patients with interstitial lung disease: results from the Registry for Better Understanding of ILD (RE-BUILD) pilot study. Respirology 2025;30:147–57.

23. Mahmoud K, Jaramillo C, Barteit S. Telemedicine in low- and middle-income countries during the COVID-19 pandemic: a scoping review. Front Public Health 2022;10:914423.

24. Edwards C, Costello E, Cassidy N, Vick B, Russell AM. Use of the patientMpower app with home-based spirometry to monitor the symptoms and impact of fibrotic lung conditions: longitudinal observational study. JMIR Mhealth Uhealth 2020;8:e16158.

25. Althobiani M, Alqahtani JS, Hurst JR, Russell AM, Porter J. Telehealth for patients with interstitial lung diseases (ILD): results of an international survey of clinicians. BMJ Open Respir Res 2021;8:e001088.

26. Podolanczuk AJ, Cottin V. A narrative review of real-world data on the safety of nintedanib in patients with idiopathic pulmonary fibrosis. Adv Ther 2023;40:2038–50.

27. Ruaro B, Pozzan R, Confalonieri P, Tavano S, Hughes M, Matucci Cerinic M, et al. Gastroesophageal reflux disease in idiopathic pulmonary fibrosis: viewer or actor? To treat or not to treat? Pharmaceuticals 2022;15:1033.

28. Kaplan B. Revisiting health information technology ethical, legal, and social issues and evaluation: telehealth/telemedicine and COVID-19. Int J Med Inform 2020;143:104239.

29. Nittari G, Khuman R, Baldoni S, Pallotta G, Battineni G, Sirignano A, et al. Telemedicine practice: review of the current ethical and legal challenges. Telemed E Health 2020;26:1427–37.

30. Hussein R, Wurhofer D, Strumegger EM, Stainer-Hochgatterer A, Kulnik ST, Crutzen R, et al. General Data Protection Regulation (GDPR) toolkit for digital health. In: Otero P, Scott P, Martin SZ, Huesing E, editors. Stud Health Technol Inform 2022. Available from: https://ebooks.iospress.nl/doi/10.3233/SHTI220066

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Published

04-08-2025

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Original Research Articles

How to Cite

1.
Monteleone G, Castelli G, Franco G, et al. Perception of the role of Telemedicine in Interstitial Lung Diseases: ­Findings from Società Italiana di Pneumologia/ Italian Respiratory ­Society (SIP-IRS) survey. Multidiscip Respir Med. 2025;20. doi:10.5826/mrm.2025.1026