The Impact of Palliative Care on Quality of Life, Anxiety, and Depression in Patients With Idiopathic Pulmonary Fibrosis
Overview
- Phase
- N/A
- Intervention
- Not specified
- Conditions
- Idiopathic Pulmonary Fibrosis
- Sponsor
- University of Minnesota
- Enrollment
- 22
- Locations
- 1
- Primary Endpoint
- Change from baseline respiratory quality of life as measured by SGRQ
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
The purpose of this study is to evaluate the effects of adding a palliative care intervention for patients with idiopathic pulmonary fibrosis (IPF) to current standard of care.
Palliative care is comprehensive, coordinated interdisciplinary care for patients and families facing a potentially life-threatening illness. This consists of specially trained teams of professionals including physicians, nurses, social workers, and chaplains that provide care and support in inpatient and outpatient settings. While the specific assistance and support provided by the Palliative Care Service depends on individual patient and family needs and preferences, it may include:
- Pain and symptom management
- Psychosocial and spiritual support
- Assistance with treatment choices
- Help in planning for care in the community
Detailed Description
Idiopathic pulmonary fibrosis (IPF) is a progressive and heterogeneous fibrotic lung disease. It is universally fatal, with an average time to death between two to five years. Patients with IPF experience significantly diminished quality of life and increased symptom burden. Besides dyspnea, cough, fatigue, and deconditioning, patients with IPF experience significant depression and anxiety. The benefit of palliative care has been demonstrated in several other diseases, notably, in metastatic lung cancer. Patients with metastatic lung cancer who were seen by palliative care at the time of their diagnosis and throughout their disease course were found to have increased survival, improved quality of life, and received less aggressive care at the end of their life. This finding has prompted significant research in the role of palliative care in other diseases, including chronic lung disease. A non-blinded, randomized trial of a multi-disciplinary breathlessness service intervention in patients with advanced disease including cancer, chronic obstructive lung disease (COPD), interstitial lung disease (ILD), and congestive heart failure demonstrated improvement in breathlessness, anxiety, and even survival. Specific Aim 1: Determine if quality of life is improved with a palliative care intervention. Specific Aim 2: Determine if depression and anxiety symptoms are decreased with a palliative care intervention. Secondary aims include an examination of pulmonary function tests (PFT), number of hospitalizations, and overall mortality as an effect of a palliative care intervention.
Investigators
Eligibility Criteria
Inclusion Criteria
- •IPF as diagnosed by chest CT or lung biopsy, and documented by a pulmonologist in the patient's medical record
- •Capacity to provide informed consent
Exclusion Criteria
- •Documented malignancy that would impact mortality within the study enrollment period
- •Inability to pay for palliative care visit, insurance or personally.
Outcomes
Primary Outcomes
Change from baseline respiratory quality of life as measured by SGRQ
Time Frame: 6 months
The Saint George's Respiratory Questionnaire (SGRQ) is 50-item survey with scores ranging from 0 to 100 and with higher scores indicating worse quality of life.
Change from baseline anxiety and depression symptoms as measured by HADS
Time Frame: 6 months
The Hospital Depression and Anxiety Index (HADS) is a 14-item survey with scores ranging from 0 to 21 and with higher scores indicating greater depression and anxiety.
Change in prevalence of baseline depression as measured by PHQ-9
Time Frame: 6 months
The Patient Health Questionnaire (PHQ-9) is a 10-item survey with scores ranging from 1 to 27 and with higher scores indicating greater levels of depression.
Secondary Outcomes
- Change from baseline of diffusing capacity(6 months)
- All-cause mortality(6 months)
- Change from baseline of lung volume(6 months)
- Change from baseline of 6-minute walk distance(6 months)
- Change from baseline of spirometry(6 months)
- Total number of hospitalizations due to any cause(6 months)