Abstract
Progressive fibrotic interstitial lung diseases (ILDs) are characterised by major reductions in quality of life and survival and have similarities to certain malignancies. However, palliative care expertise is conspicuously inaccessible to many patients with ILD. Unmet patient and caregiver needs include effective pharmacological and psychosocial interventions to improve quality of life throughout the disease course, sensitive advanced care planning, and timely patient-centred end-of-life care. The incorrect perception that palliative care is synonymous with end-of-life care, with no role earlier in the course of ILD, has created a culture of neglect. Interventions that aim to improve life expectancy are often prioritised without rigorous assessment of the individual's health and psychosocial needs, thereby inadvertently reducing quality of life. As in malignant disorders, radical interventions to slow disease progression and palliative measures to improve quality of life should both be prioritised. Efficient patient-centred models of palliative care must be validated, taking into account religious and cultural differences, as well as variability of resources. Effective implementation of palliative care for ILD will require multidisciplinary participation from clinicians, specialist nurses, psychologists, social workers, and, in some countries, non-governmental faith and community-based organisations with access to palliative care expertise.
Original language | English |
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Pages (from-to) | 968-980 |
Number of pages | 13 |
Journal | The Lancet Respiratory Medicine |
Volume | 5 |
Issue number | 12 |
DOIs | |
Publication status | Published - Dec 2017 |
Bibliographical note
Funding Information:NC reports grants from Boehringer Ingelheim and Roche Products Ireland, and other funding from Roche, provided to the Irish Lung Fibrosis Association. AW reports personal fees from Boehringer Ingelheim, Intermune/Roche, Bayer, and Chiesi. A-MR reports grants and personal fees from F Hoffman-La Roche. TJC reports grants and personal fees from Boehringer Ingelheim and Roche; grants from Bayer, BMS, Actelion, and Sanofi; and personal fees from AstraZeneca. KJ reports personal fees and non-financial support from F Hoffman-La Roche and Boehringer Ingelheim and grants from UCB Biotech. RK reports personal fees from Roche and Boehringer Ingelheim. MKo reports grants from Canadian Pulmonary Fibrosis Foundation and the Canadian Institute for Health Research; other funding from Roche, Sanofi, and Boehringer Ingelheim; grants and other funding from the Pulmonary Fibrosis Foundation; grants and personal fees from Roche Canada and Janssen; and personal fees from Boehringer Ingelheim, GlaxoSmithKline, AstraZeneca, Vertex, Genoa, Gilead, Prometic, and Alkermes. YK reports advisory board fees and personal fees from Asahi Kasei Pharma and personal fees from Boehringer Ingelheim, Eisai, Kyorin Pharmaceutical, Novartis Pharma, Shionogi & Co, and Teijin Pharma, outside of the work. MKr reports grants and personal fees from Boehringer Ingelheim and Roche/InterMune. SQ reports grants from Boehringer Ingelheim. MW reports grants and other funding from Boehringer Ingelheim and Intermune/F Hoffman La-Roche and other funding from Galapagos. All other authors declare no competing of interests.
Publisher Copyright:
© 2017 Elsevier Ltd
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine