Background Idiopathic pulmonary fibrosis (IPF) is a rare, progressive and severe disease characterised by a progressive decline in lung function, with a dismal median survival of 3 years. Despite the recent introduction of antifibrotic agents, there was no standardised collaborative disease management pathway for IPF that described the IPF clinical pathway from the therapeutic decision to drug delivery and patient follow-up for both hospital pharmacists and pulmonologists.
Purpose The objective of the project was to propose a cooperative working method between pulmonologists and hospital pharmacists, share experiences to stimulate cooperation and establish, for the first time, a disease management pathway for IPF patients.
Material and methods Six workshops involving 34 hospital pharmacists and 14 pulmonologists were organised between November and December 2015 across Spain to discuss and share views on the IPF patient pathway and depict the involvement of the hospital pharmacist throughout the patient journey in terms of objectives, tasks and recommendations. The project was supported by the Spanish Society of Hospital Pharmacy and the Spanish Society of Pulmonology and Thorax Surgery.
Results A consensual IPF patient pathway was established and divided into four phases: (1) detection of IPF cases; (2) diagnosis and treatment selection; (3) initiation of pharmaceutical treatment; and (4) patient follow-up. A number of activity checklists were established for each phase and for each healthcare professional. Direct involvement of hospital pharmacist was described for 29 activities. 4 (14%) were related to inhospital interdisciplinary contributions while 25 (86%) were directly related to interactions with patients. In 17 cases (58%) information generated from the hospital pharmacist could be shared with the pulmonologist to take therapeutic or educational decisions.
Conclusion The elaboration of activity checklists will facilitate the implementation of the consensus document. A closer collaboration between hospital pharmacists and pulmonologists will result in helping choose the most adequate treatment, speeding up treatment initiation, optimising the treatment, better accompanying the patient and fostering an effective communication between professionals. In the future, it will be important to quantitatively assess the importance of pharmaceutical care in IPF patients.
Conflict of interest:
Corporate sponsored research or other substantive relationships: Boehringer Ingelheim Spain funded this project.
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