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Early referral to palliative care services in patients with IPF: a tool to take a step forward
  1. Paola Faverio1,
  2. Federica De Giacomi1,
  3. Grazia Messinesi1,
  4. Alessia Fumagalli2 and
  5. Fabrizio Luppi1
  1. 1 School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Respiratory Unit, San Gerardo Hospital, ASST di Monza, Monza, Italy
  2. 2 Unit of Pulmonary Rehabilitation, Research Hospital of Casatenovo, Italian National Research Centre on Aging (INRCA), Casatenovo, Italy
  1. Correspondence to Dr Paola Faverio, School of Medicine and Surgery, University of Milano-Bicocca, Monza 20900, Italy; paola.faverio{at}gmail.com

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Dear Dr Walsh,

We read with great interest the systematic review by Kim et al who summarised the barriers encountered by clinicians for the referral of patients with interstitial lung diseases (ILDs) to specialist palliative care services.1

ILDs are a heterogeneous group of more than 200 lung diseases that result in involvement of the alveolar interstitium, in addition to alveolar structures and small airways potentially leading to an impairment of gas exchange. The different clinical course, prognosis and available treatments make it challenging for clinicians to identify the need and the correct timing for palliative care referral in patients with ILDs.2

However, even in those characterised by disease progression, such as idiopathic pulmonary fibrosis (IPF), the referral is late or lacking in most of the cases.

Therefore, an objective tool would be helpful in identifying patients who require palliative care.1

In this scenario, a guide for the referral to …

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