Feasibility and efficacy of a multidisciplinary palliative approach in patients with advanced interstitial lung disease. A pilot randomised controlled trial
I Bassi, A Guerrieri, M Carpano, A Gardini, I Prediletto, M Polastri, J Randall Curtis, S Nava, I Bassi, A Guerrieri, M Carpano, A Gardini, I Prediletto, M Polastri, J Randall Curtis, S Nava
Abstract
Introduction and objectives: Interstitial lung diseases (ILDs) encompass a heterogeneous group of parenchymal lung disorders which have a significant burden on quality of life and exercise. The primary purpose of this randomised pilot trial performed in advanced ILD was to determine the feasibility and efficacy of a multidisciplinary palliative care approach (including physiotherapist, psychologist, pulmonologists, and palliative care doctors) to relieve patients' symptoms of dyspnoea, depression measured with the Center for Epidemiological Studies-Depression (CES-D) scale and quality-of-life (QoL) at 6 and 12 months.
Matherials and methods: Fifty patients with confirmed interstitial lung disease at computed tomography (CT) scan and advanced disease were enrolled at our clinic. Patients were randomised to usual care group vs intervention group; in the intervention group, patients were scheduled to meet a physiotherapist, a psychologist, a palliative care doctor, and a pulmonologist specialized in ILD care. Data on dyspnoea, cough, quality of life and depression were recorded; patients in the intervention group were also tested to assess lower body flexibility and strength.
Results: Both groups showed a worsening in dyspnoea during the time course of the trial, but the Borg scale was less in the intervention group at 6 and 12 months. A similar trend was observed also for the CES-D scale. No differences were observed for the other scales.
Conclusions: A multi-disciplinary palliative care intervention in patients with advanced fibrosing interstitial lung disease is feasible and effective.
Trial registration: NCT02929966 on ClinGovTrial.
Keywords: Lung disease; Palliative care; Physical therapy modalities; Psychology; interstitial.
Conflict of interest statement
Conflicts of interest The authors declare that there is no conflict of interest.
Copyright © 2021 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.
Source: PubMed