Combined ILD and palliative care services improves access to community palliative care

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Introduction: Interstitial lung disease (ILD) is associated with high rates of morbidity and mortality. Evidence suggests that early palliative care involvement can improve accordance with end-of-life care wishes, including location of death. Our centre introduced an ILD Palliative Care multidisciplinary team (MDT) in 2021, and in 2023, a combined ILD and Palliative Care clinic was launched to further support our patients. Methods: A retrospective audit was performed on prospectively collected data on deceased patients within the ILD service, who died between 01/06/2021 to 31/12/2024. The audit assessed changes in referral rates to community palliative care following the introduction of the ILD Palliative Care MDT and combined clinics, as well as the percentage of patients dying at home or in hospice. Results: Of 98 deceased patients, the proportion referred to community palliative care increased significantly following the introduction of combined clinics in 2023: 38% (2021), 40% (2022), 50% (2023), 69.7% (2024). Of all patients who died at home or hospice (n=40), 90% were linked with community palliative care and 7.5% were referred as an inpatient. Only 1 patient not known to palliative care died at home. 65% of patients discussed at the ILD palliative care MDT died at home or in hospice. Conclusion: In our service, dying at home or hospice is largely dependent on community palliative care input. Community palliative care referrals have significantly increased following the introduction of the ILD palliative care MDT and combined clinics.

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