Development of a consensus statement for the definition, diagnosis, and treatment of acute exacerbations of idiopathic pulmonary fibrosis using the Delphi technique
Author(s)
Type
Journal Article
Abstract
INTRODUCTION: There is a lack of agreed and established guidelines for the treatment of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). This reflects, in part, the limited evidence-base underpinning the management of AE-IPF. In the absence of high-quality evidence, the aim of this research was to develop a clinician-led consensus statement for the definition, diagnosis and treatment of AE-IPF. METHODS: A literature review was conducted to obtain published material on the definition and treatment of AE-IPF. The results of this review were circulated to an online panel of clinicians for review. Statements were then shared with ten expert respiratory clinicians who regularly treat patients with IPF. A Delphi technique was then used to develop a consensus statement for the definition, diagnosis and treatment of AE-IPF. During the first round of review, clinicians rated the clarity of each statement, the extent to which the statement should be included and provided comments. In two subsequent rounds of review, clinicians were provided with the group median inclusion rating for each statement, and any revised wording of statements to aid clarity. Clinicians were asked to repeat the clarity and inclusion ratings for the revised statements. RESULTS: The literature review, online panel discussion, and face-to-face meeting generated 65 statements covering the definition, diagnosis, and management of AE-IPF. Following three rounds of blind review, 90% of clinicians agreed 39 final statements. These final statements included a definition of AE-IPF, approach to diagnosis, and treatment options, specifically: supportive measures, use of anti-microbials, immunosuppressants, anti-coagulants, anti-fibrotic therapy, escalation, transplant management, and long-term management including discharge planning. CONCLUSION: This clinician-led consensus statement establishes the 'best practice' for the management and treatment of AE-IPF based on current knowledge, evidence, and available treatments.
Date Issued
2015-10-23
Date Acceptance
2015-10-23
Citation
Advances in Therapy, 2015, 32 (10), pp.929-943
ISSN
1865-8652
Publisher
Springer Verlag
Start Page
929
End Page
943
Journal / Book Title
Advances in Therapy
Volume
32
Issue
10
Copyright Statement
© The Author(s) 2015. This article is distributed under the terms of the Creative Commons
Attribution-NonCommercial 4.0 International
License (http://creativecommons.org/licenses/
by-nc/4.0/), which permits any noncommercial
use, distribution, and reproduction in any
medium, provided you give appropriate credit
to the original author(s) and the source, provide
a link to the Creative Commons license, and
indicate if changes were made.
Attribution-NonCommercial 4.0 International
License (http://creativecommons.org/licenses/
by-nc/4.0/), which permits any noncommercial
use, distribution, and reproduction in any
medium, provided you give appropriate credit
to the original author(s) and the source, provide
a link to the Creative Commons license, and
indicate if changes were made.
License URL
Identifier
PII: 10.1007/s12325-015-0249-6
Subjects
Acute exacerbations
Acute lung injury
Best practice
Consensus statement
Definition
Diagnosis
Idiopathic pulmonary fibrosis
Interstitial lung disease
Qualitative research
Treatment
General Clinical Medicine
1115 Pharmacology And Pharmaceutical Sciences
Publication Status
Published
Coverage Spatial
United States