Table 2 Specialist competencies within the ILD multidisciplinary care team
From: Walking the path of treatable traits in interstitial lung diseases
Specialist | Competencies | Treatable trait areas of focus |
|---|---|---|
Chest physician (coordination of the multidisciplinary team) | ✓ Diagnosis confirmation and investigation of etiology ✓ Performance and evaluation of PFTs ✓ Bronchoscopy ✓ Medication review (side effects of treatment and polypharmacy review) ✓ Ensure patient’s adherence to treatment ✓ Management of respiratory failure, LTOT, NIV ✓ Identification of patients who are candidates for lung transplant ✓ Identification and management of acute exacerbations ✓ Identification of patients eligible for RCTs ✓ Monitoring of disease severity and potential complications ✓ End-of-life care | ✓ Etiological ✓ Lifestyle ✓ Pulmonary ✓ Comorbidities |
Rheumatologist | ✓ CTD suspicion and diagnosis ✓ Identification of extra-respiratory involvement ✓ Co-management and prescription of immunosuppressive and antifibrotic drugs | ✓ Etiological ✓ Comorbidities |
Physiotherapist and/or respiratory therapist | ✓ Airway clearance ✓ Pulmonary rehabilitation ✓ Inhaled therapy management | ✓ Lifestyle ✓ Pulmonary |
Nurse | ✓ Coordinate input of other healthcare professionals ✓ Support patients and their families to recognize symptoms so as to avoid complications ✓ Ensure patient’s adherence to treatment | ✓ Lifestyle |
Pathologist | ✓ Support etiological diagnosis ✓ Identification of progressive fibrosis ✓ Identification of complications | ✓ Etiological ✓ Comorbidities |
Radiologist | ✓ Support etiological diagnosis ✓ Identification of progressive fibrosis ✓ Identification of AE ✓ Identification of complications | ✓ Etiological ✓ Comorbidities |
Gastroenterologist | ✓ Diagnosis and management of GERD ✓ Management of gastrointestinal side effects of treatment (e.g.: antifibrotics) ✓ Evaluation and management of extra-respiratory involvement | ✓ Comorbidities |
Geneticist | ✓ Diagnosis of genetic disorders ✓ Genetic counseling for patient and relatives | ✓ Lifestyle ✓ Etiological |
Infectious disease specialist | ✓ Advice on potential prophylaxis in patients treated with immunosuppressive drugs ✓ Treatment of acute and chronic infection | ✓ Multisystem |
Cardiologist | ✓ Diagnosis and management of RHF ✓ Evaluate heart involvement in some ILDs (e.g.: sarcoidosis or scleroderma) | ✓ Comorbidities |
Psychologist | ✓ Management of anxiety and depression ✓ Family support ✓ End-of-life care | ✓ Lifestyle |
Endocrinologist | ✓ Diagnosis and management of osteoporosis and diabetes in patients treated with chronic steroid therapy | ✓ Comorbidities |
Nutritionist | ✓ Diet instruction | ✓ Lifestyle ✓ Comorbidities |
Geriatrician | ✓ Identification of frail patients ✓ Medication review ✓ Familial and social support | ✓ Lifestyle ✓ Comorbidities |
Pharmacologist | ✓ Medication review (side effects of treatment and polypharmacy review) ✓ End-of-life care | ✓ Pulmonary |
Thoracic Surgeon | ✓ Surgical biopsy ✓ Co -management of lung cancer ✓ Lung transplant | ✓ Etiological ✓ Comorbidities |
General practitioner | ✓ Medication review (side effects of treatment and polypharmacy review) ✓ Ensure patient’s adherence to treatment ✓ Support patients and their families to recognize symptoms so as to avoid complications ✓ End-of-life care | ✓ Lifestyle ✓ Pulmonary ✓ Comorbidities |