Cura Personalis: Bringing Care to the Whole Person with Idiopathic Pulmonary Fibrosis
Nature and scope of the project
Idiopathic pulmonary fibrosis (IPF) is a life-limiting chronic interstitial lung disease with symptoms of cough, shortness of breath, fatigue, anxiety, and depression. Palliative care (PC) aims to treat such symptoms for seriously ill patients.
Synthesis and analysis of supporting literature
PC barriers include lack of availability, devaluation of PC discussion, insufficient screening tools, and inadequate referral guidelines. Using the Knowledge to Action Framework, this project sought to improve IPF provider PC knowledge, attitudes, and practices (KAP).
Project implementation
IPF providers received training on the Needs Assessment Tool: Progressive Disease-Interstitial Lung Disease (NAT: PD-ILD)and PC focused education (patient-centered communication, PC information, patient PC resource guide). Providers were asked to use the NAT: PD-ILD in IPF patient encounters and document findings in the electronic medical record (EMR). Semi-structured interviews assessed provider KAP pre- and post-intervention.
Evaluation criteria
Content analysis was performed by three independent reviewers, examining interview transcripts for themes. NAT: PD-ILD frequency of use was evaluated during the intervention period. Frequency of PC discussion and referral rates in the EMR were compared between the 2023 intervention period and the same 2022 pre-intervention period.
Outcomes
Participants (n=3) reported increased comfort with discussing PC and the use of NAT: PD-ILD to facilitate discussions and referral. The NAT: PD-ILD was used in 47% of eligible encounters, resulting in a 22% discussion rate and 17% referral rate in the intervention period, up from 3% in the same period the prior year.
Recommendations
Results support ongoing use of the tool and expansion to other staff, including other pulmonologists and nurses. Efforts should be made to develop the tool into a flowsheet in the Electronic Medical Record. Consideration should be given to integrating specialty PC practice in the ILD clinic.
Cura Personalis: Bringing Care to the Whole Person with Idiopathic Pulmonary Fibrosis