Care for Australians with idiopathic pulmonary fibrosis (IPF) is generally delivered in line with best practice guidance, but patients and clinicians face numerous practical barriers with multidisciplinary meeting (MDM) teams, a study shows.
A survey of IPF services at 39 public hospitals found that almost all of them provided care via MDMs that aligned with suggestions made in position statements published by the Thoracic Society of Australia and New Zealand (TSANZ) and Lung Foundation Australia (LFA).
However while 90% of MDM teams included expert respiratory physicians and radiologists;, about 60% did not include a rheumatologist or interstitial lung disease nurse and about a quarter did not have a histopathologist.
The study, led by researchers from Monash University, Melbourne, also showed that more than 90% of institutions had access to oxygen therapy, pulmonary rehabilitation and advanced care planning. However only about half (53%) had access to psychological support and 58% had access to clinical trials, and around 60% of hospitals had a dedicated ILD clinic.
Interviews with fifteen respiratory physicians produced feedback that all supported this model of care and their approaches to diagnosis, treatment and access to referral services for people with IPF were generally consistent with best practice guidance.
But many clinicians reported practical barriers to accessing MDM teams, particularly for those in regional hospitals. Issues often centred around the infrequency of meetings and lack of ILD specialised staff.
“I think escalating and improving things to a weekly or fortnightly meeting… the biggest issue would actually be staff availability,” said one respondent.
“We’re all pretty good at respiratory radiology, at least HRCT interpreters ourselves but we don’t have a specialized radiologist at that meeting,” said another.