Young adults and children with cystic fibrosis (CF) in the United States have better lung function than those who live in the United Kingdom, despite the fact that both countries have well-developed healthcare systems.

Differences in lung function may be a result of differences in healthcare structure, according to the authors of “Children and Young Adults in the USA Have Better Lung Function Compared with the UK,” which was published in the journal BMJ Thorax.

In the United States, it is common for patients to be treated only at specialist centers, whereas in the United Kingdom, patients generally see a specialist once a year and see a pediatrician, rather than a cystic fibrosis expert, in the interim.

On top of frequent specialized care, American patients receive different therapies than those in the United Kingdom. Chronic pulmonary therapies and chronic macrolide antibiotics are used more often in the United States, and the use of hypertonic saline and rhDNase is most strikingly different.

“At this stage there is a lot more work to do to identify the cause of the differences,” stated Dr Diana Bilton, one of the study authors from Royal Brompton Hospital and Chair of the UK Cystic Fibrosis Registry steering committee, in a news report. “It is important that we all look at our practice as a result of his paper and check whether we are using the medicines already available in the best way. We also need to look at how we deliver care.”