Interstitial lung disease: multidisciplinary outpatient palliative care service

To facilitate earlier access to palliative care (PC) for interstitial lung disease (ILD) patients, a combined ILD-PC clinic was launched at Royal Prince Alfred Hospital. We describe referral patterns and clinical practice 16 months post-implementation.

A review of consecutive patients referred to the ILD-PC clinic was performed. Reasons for referral, PC interventions implemented and clinical outcomes were documented.

36 patients were referred to the ILD-PC clinic (75±8 years; 57% men). Diagnoses included idiopathic pulmonary fibrosis (49%), unclassifiable ILD (14%), chronic hypersensitivity pneumonitis (14%) and connective tissue disease-associated ILD (11%). Reasons for referral included high symptom burden (91%), advanced disease (66%) and disease progression (49%). PC management strategies encompassed symptom management (60%), referral to community PC services (40%), advance care planning (26%) and the prescription of opioids and benzodiazepines (23%). During the follow-up period, 23% of patients self-reported worsening symptoms, 40% demonstrated lung function decline, 11% died and 6% were listed for lung transplantation.

The ILD-PC clinic incorporates a multidisciplinary, patient-centred approach to ILD care by enabling early access to symptom management, community services and advance care planning.