Partnership delivery of symptom management at a UK ILD centre

<bold>Introduction:</bold> Individuals with pulmonary fibrosis can have complex symptoms. Early palliative care (PC) is recommended, though with little evidence on the balance of support between specialist respiratory and PC teams to deliver this in progressive disease. <bold>Aim:</bold> Assess delivery of symptom management in patients with severe lung function impairment at a UK ILD centre. Delivery of nurse support is examined against disease trajectory. Symptom management interventions are examined including support delivered via specialist PC teams. <bold>Methodology:</bold> A retrospective analysis of 71 patients initiating antifibrotic treatment with a baseline TLco <50%. Palliative care need was compared with disease trajectory based on stable or deteriorating TLco over a year. Data was derived from clinical records of the Oxford ILD service. <bold>Results:</bold> 41% of patients had support for breathlessness and cough, 32% breathlessness and 11% cough alone delivered by ILD nurses. 33% with deteriorating disease were referred to specialist PC. Referral rationale reflected broader patient need; initial PC plans focused on benefits advice, future planning, and occupational therapy. Specialist PC support enabled patient choice of place of death. <bold>Conclusion:</bold> Initial specialist PC focused on areas which transcend specific symptoms. Community PC support has a positive impact through to end-of-life. A joint ILD/PC nurse post and MDT will be created to enable specialist PC input at an earlier stage. <fig><object-id>erj;64/suppl_68/OA5451/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>