Palliative Care in Interstitial Lung Disease: With the “Who,” We Need the What, When, Where, and How.

Outcomes 1. Understand the inter-professional needs of patients with interstitial lung disease. 2. Describe the implementation and impacts of palliative management in interstitial lung disease. Key Message While the importance of palliative care (PC) to support patients with end-stage lung disease (ESLD), such as interstitial lung disease (ILD) is known, this interactive presentation will describe the importance of early PC intervention to improve patient and family quality of life. Background End-stage lung disease (ESLD), specifically interstitial lung disease (ILD), causes great symptom burden, decreased functional status, and anticipatory grief. Although the literature supports the role of palliative care (PC) to aid patients with ILD, optimal timing of referral, need for specialized care, and access to care remain unclear.1 This case presentation reviews 3 unique cases, illustrating the necessity and dramatic benefits of early PC intervention. Methods This outpatient palliative care clinic partnered with the institution-wide multidisciplinary ILD team to improve access to PC for ILD patients. A telemedicine program was developed and a retrospective chart analysis from July 1, 2022 – July 1, 2023, reviewed patient complexity, interventions, timelines, and outcomes. Results Patients with ILD represented 12% of patients seen in clinic. They had a lower no-show rate (8% vs 19% for first appointment) and 11% higher utilization rate of telemedicine. They had double the average PC follow-up and a 27% higher than average admission rate to hospice. This interactive presentation reviews this data and narrates the stories of 3 unique patients with ESLD with various complex medical courses. CK, a 71-year-old woman with ILD happened upon PC by accident and had more follow-ups than any other patient, plus prolonged survival. JB, a 65-year-old veteran with advanced COPD, PTSD, suicidal ideation, was referred for advance care planning, and had drastically improved mental health and quality of life after dyspnea management. PS, a 76 year-old woman presented to PC requesting euthanasia and subsequently enrolled in a 3-month inpatient clinical trial, after symptom management and supportive family meetings. Conclusion Patients with ESLD represent a unique, often over-looked, under-resourced population. This presentation demonstrates the significance and profound impact of early PC. Keywords Emergencies / Refractory Symptom Management Managing Suffering and Distress