{
  "abstract": "Background Patients with Interstitial Lung Disease (ILD) have poorer access to specialist end of life care, experiencing a higher symptom burden than lung cancer patients, with more breathlessness, pain, and anxiety (Ahmadi, Wysham, Lundström, et al. Thorax. 2016;71(6):510-6). The NCEPOD End of Life report (Planning for the end. NCEPOD; 2024) identified missed opportunities for advance care planning (ACP) and ReSPECT conversations. ILD patients may not access timely hospice services due to unpredictable decline.Our frailty project with the virtual ward team showed people with respiratory disease often needed earlier palliative conversations. We embedded this learning through proactive support in the ILD clinic.Aims The clinic would enhance holistic care for ILD patients with frailty, enabling proactive discussions, symptom control, parallel planning, and well-documented decision-making using ReSPECT and ACP. Self-assessed well-being demonstrates improvement.Method The hospice respiratory physiotherapist joined the hospital ILD clinic. Holistic symptom identification and targeted management strategies, along with onward referral when required. Where appropriate, ReSPECT and ACP discussions were undertaken. Physiotherapist to explore and manage symptoms/concerns. Patients had a follow-up phone call. Rockwood scores used to select patients with frailty. Outcome measures were captured using ReSPECT, ACP, MyCaW (https://www.meaningfulmeasures.co.uk/mycaw) and Mastery Scores pre and post.Results 26 patients were seen. Patients had targeted interventions for cough, breathlessness, fatigue and support strategies.Overwhelmingly positive patient, family and staff feedback:46% ReSPECT discussions in clinic, 46% follow-up.38% ACP discussions in clinic, 42% follow-up.46% Mastery improvement in main symptom.69% MyCaW improvement.Average MyCaW improvement: 3.4.Conclusion The value of holistic care for patients with ILD highlights the need for time to talk. Expertise in symptom management, physiotherapy, and breathlessness support has been invaluable for patients with heavy symptom burdens. Parallel planning is essential, these patients may have acute exacerbations that could be fatal but may also recover with treatment, making a 1-year prognosis nearly impossible.",
  "authors": [
    {
      "affiliations": [
        "Prospect Hospice, Wroughton, UK"
      ],
      "name": "Carolyn Bell"
    },
    {
      "affiliations": [
        "Prospect Hospice, Wroughton, UK"
      ],
      "name": "Naomi McKenna"
    }
  ],
  "title": "P-15 Collaborative palliative care: advancing early conversations for patients with interstitial lung disease and frailty",
  "uid": "8bc8135d-452a-56b2-a974-3fc1db7f5449"
}