ERJ open research · 2026
Mapping challenges in the delivery of care for primary ciliary dyskinesia: an international survey on barriers and priorities.
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Rubbo Bruna, Behan Laura, Newman Lydia M, Coles Janice, Goodwin John, Hirst Robert A, Jackson Claire L, Driessens Corine, Goutaki Myrofora, Kuehni Claudia E, Lucas Jane S
Аннотация
BACKGROUND: Primary ciliary dyskinesia (PCD) is a rare genetic disorder causing chronic multisystemic symptoms due to impaired motile ciliary function. Diagnosis and care of PCD requires specialised, resource-intensive laboratory and clinical services, which are often unavailable in settings with limited resources. We compared the opinions of PCD healthcare professionals on the barriers to and priorities of delivering care for people with PCD to inform strategies for improvement.
METHODS: We conducted a mixed-methods study comprising semi-structured interviews with PCD healthcare professionals, followed by an electronic survey guided by interview findings. We classified participants' countries by gross national income (GNI) to enable comparisons across settings.
RESULTS: We conducted 15 interviews across 13 countries, identifying key barriers and priorities through content analysis. 128 participants from 35 countries completed the survey. Common barriers included lack of PCD awareness among non-specialist clinicians, underestimation of disease severity, insufficient funding and limited time for clinical and research activities. Priorities were raising awareness, disseminating referral guidelines and enhancing collaboration between centres. Participants from countries with a high GNI highlighted the lack of evidence-based guidelines for clinical management as an important barrier, and the need for multidisciplinary teams as a priority. Participants from countries with a low GNI emphasised limited prioritisation of PCD by adult clinicians and high diagnostic cost as barriers, and access to experienced diagnostic personnel and tests as priorities.
CONCLUSION: Our findings inform a shared roadmap for improving PCD care. We highlight the need for future research to identify systemic, contextual and modifiable factors influencing access, management and funding for PCD across service delivery models.
METHODS: We conducted a mixed-methods study comprising semi-structured interviews with PCD healthcare professionals, followed by an electronic survey guided by interview findings. We classified participants' countries by gross national income (GNI) to enable comparisons across settings.
RESULTS: We conducted 15 interviews across 13 countries, identifying key barriers and priorities through content analysis. 128 participants from 35 countries completed the survey. Common barriers included lack of PCD awareness among non-specialist clinicians, underestimation of disease severity, insufficient funding and limited time for clinical and research activities. Priorities were raising awareness, disseminating referral guidelines and enhancing collaboration between centres. Participants from countries with a high GNI highlighted the lack of evidence-based guidelines for clinical management as an important barrier, and the need for multidisciplinary teams as a priority. Participants from countries with a low GNI emphasised limited prioritisation of PCD by adult clinicians and high diagnostic cost as barriers, and access to experienced diagnostic personnel and tests as priorities.
CONCLUSION: Our findings inform a shared roadmap for improving PCD care. We highlight the need for future research to identify systemic, contextual and modifiable factors influencing access, management and funding for PCD across service delivery models.