113 The swinburne slot: a clinic-based service for deteriorating patients with interstitial lung disease

Abstract

Methodology Using Shropshire Doctors Co-operative Ltd (Shropdoc's) recorded data we have collated a representative picture of the palliative care practice over a year period from 161 OOHGP patient interactions. Results 31% of home visits (HV) had documentation of potential reversible factors and out of those 72% were with the patient's estimated prognosis greater than 48 hours. Infection being the most common (57%) reversible factor, the majority being a lower respiratory tract infection. Overall 5.7% of OOH GP palliative HV's resulted in hospital admission, however this decreased to 0.6% adjusting for an estimate of the patient's prognosis to be less than 48 hours. 16% were admitted if the patient had a potentially reversible co-existing condition. 33% of consultations had documentation regarding a continuous subcutaneous infusion (CSCI), 86% of CSCI interventions were made with a prognosis of less than 48 hours. There were CSCI infusion issues requiring an OOHGP 3.4% of the time. Overall anticipatory medications were prescribed 39% of the time. Conclusion The OOHGP deals with a wide variety of scenarios for a heterogeneous population. The symptoms and treatments instigated are on the most part expected within emergency palliative care. This data begins to quantify and describe the role being performed by OOHGP and has implications for service provision and potentially the necessity of 24 hour specialist palliative provision.

When should palliative care be introduced for people with progressive fibrotic interstitial lung disease? A meta-ethnography of the experiences of people with end-stage interstitial lung disease and their family carers

“…A novel rapid clinic review pathway was developed in the UK by Newcastle-upon-Tyne Hospitals interstitial lung disease service for patients who required urgent ad-hoc review. 68 Patients were reviewed urgently in the clinic and were referred for appropriate investigations, started on treatment for intercurrent illness and many were also reviewed by palliative care services on the same day. Feedback from this service indicated that patients and their carers felt supported as they were able to be reviewed by the interstitial lung disease specialists quickly, which avoided delays which may have been fostered by repeated visits in primary care.…”