{
  "abstract": "Introduction Nintedanib and pirfenidone reduce the rate of progression in fibrotic lung diseases. Until 2024 these medications could only be prescribed by tertiary specialist centres in England. We have piloted a tier 2 prescribing service in secondary care, in accordance with the objectives of the One Voice ILD integrated care pathway for optimum ILD care. 1 We report the outcomes from the first 6 months of antifibrotic prescribing in our trust.Methods A retrospective review of patients discussed in the regional ILD MDT and given approval to start anti-fibrotic medications between December 2024 and June 2025. A patient satisfaction survey was sent to the first 53 surviving patients.Results 62 patients were approved to start treatment. 48/62 patients were male, mean age 73 years (range 45–87). 55/60 started Nintedanib, 5/60 Pirfenidone. 1 patient declined treatment, 1 has delayed treatment start.All had a consultation with an ILD specialist nurse and/or pharmacist. All patients had monthly blood tests as scheduled and received a follow up phone call within the first month.At 3 months, 24/30 continued antifibrotic medication, 1 patient had died of progressive IPF, 4 had stopped due to side effects, 1 had treatment paused. Dose reduction was required in 17/60 patients. In comparison, of 39 patients from our trust who started antifibrotics in 2024, 30 remained on treatment at 3 months, 10 had dose reduction.57/62 (92%) were approached about the BTS ILD registry, 26/62 have consented to participate thus far. 2 are actively considering clinical trials.Patient satisfaction was high (survey response rate 24/53). All reported they knew who to contact with problems and found it ‘quite easy’ or ‘very easy’ to obtain advice on side effects. 21/24 patients preferred having all their care in-trust. 3/24 had no preference.Conclusion Antifibrotics can be prescribed safely and effectively in Tier 2 centres. This approach provides care closer to home, improves continuity of care and monitoring with excellent patient satisfaction. Resources are needed to ensure access to other aspects of care, including research and registries.Reference One Voice ILD Group. ILD Care Pathway [online]. Available from: https://cdn.prod.website-files.com/5e32c31d3ab26b41eba332b2/661fc1e24752a5ebfbbfd567_OneVoiceILD%20Care%20Pathway%20report.pdf",
  "authors": [
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "J Sutanto"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "W Angwin"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "W Ong"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "E Payne"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "R Henderson"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "G Barrett"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "L Mackay"
    },
    {
      "affiliations": [
        "Northumbria Healthcare NHS Foundation Trust, Ashington, UK"
      ],
      "name": "S Haney"
    }
  ],
  "title": "P132 Antifibrotic prescribing in a tier 2 centre: the ILD integrated clinical care pathway in practice",
  "uid": "b7052532-4b3b-5a8c-ba39-7a2bb1be3514"
}