Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Lung Precision Medicine, Department for BioMedical Research, University of Bern, Bern, Switzerland.
Department for Pulmonary Medicine, Allergology and Clinical Immunology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Chest. 2024 Aug;166(2):352-361. doi: 10.1016/j.chest.2024.02.045. Epub 2024 Mar 4.
A diagnosis of interstitial lung diseases (ILD) can be challenging, and the identification of an associated connective tissue disease (CTD) is crucial to estimate prognosis and to establish the optimal treatment approach. Diagnostic delay, limited expertise, and fragmented care are barriers that impede the delivery of comprehensive health care for patients with rare, complex, and multiorgan diseases such as CTD and ILD. In this article, we present our perspective on the interdisciplinary diagnosis and interprofessional treatment of patients with ILD and suspected CTD or CTD at risk of ILD. We outline the structure of our service, delineating the roles and responsibilities of the team members. Additionally, we provide an overview of our patient population, including diagnostic approaches and specific treatments, and illustrate a patient case. Furthermore, we focus on specific benefits and challenges of joint interdisciplinary and interprofessional patient consultations. The importance of rheumatology and pulmonology assessments in specific patient populations is emphasized. Finally, we explore future directions and discuss potential strategies to improve care delivery for patients with CTD-associated ILD.
间质性肺疾病(ILD)的诊断具有挑战性,确定相关的结缔组织病(CTD)对于评估预后和确定最佳治疗方法至关重要。诊断延误、专业知识有限以及医疗服务碎片化,这些障碍阻碍了为患有罕见、复杂和多器官疾病(如 CTD 和 ILD)的患者提供全面医疗保健。在本文中,我们介绍了我们对ILD 和疑似 CTD 或有ILD 风险的 CTD 患者的跨学科诊断和跨专业治疗的观点。我们概述了我们服务的结构,划定了团队成员的角色和责任。此外,我们还提供了患者人群的概述,包括诊断方法和具体治疗方法,并举例说明了一个患者病例。此外,我们重点介绍了联合跨学科和跨专业患者咨询的具体益处和挑战。强调了在特定患者群体中进行风湿病学和肺病学评估的重要性。最后,我们探讨了未来的方向,并讨论了改善 CTD 相关 ILD 患者护理的潜在策略。