11th January 2024

Conservative measures

Supportive care plays a crucial role and should be considered in all patients at the time of diagnosis.

• Pulmonary rehabilitation – every patient diagnosed with ILD should be assessed for the need for pulmonary rehabilitation. It should be offered to those whose quality of life is significantly affected by the disease, e.g. those with low exercise tolerance. Sessions include information on the condition, nutritional advice, breathing exercises, psychological support, and social network opportunities.
• Long-term oxygen therapy (LTOT) – many patients with ILD may require supplemental oxygen if/as the disease progresses; this is particularly relevant for IPF patients who almost universally develop hypoxia. It is important to recognise the point where it needs to be initiated in order to preserve patient’s quality of life, as well as avoid or minimise complications of chronic hypoxia, such as pulmonary hypertension and polycythaemia.
• Smoking cessation – should be advised to all patients with ILD
• Minimising risk of chest infections – annual flu vaccination and pneumococcal vaccination should be offered to all patients. Those with frequent exacerbations can be offered prophylactic antibiotics. Whenever possible, antibiotic choice should be guided by sensitivities of patient’s sputum culture.