title: Optimizing quality of life in patients with idiopathic pulmonary fibrosis.
abstract: Idiopathic pulmonary fibrosis (IPF) is a devastating, progressive and ultimately fatal lung disease. The combination of poor prognosis, uncertainty of disease course and severe symptom burden heavily impacts patients' and their families' quality of life. Though new antifibrotic drugs have been shown to decrease disease progression, the effect on health-related quality of life (HRQOL) has not been convincingly demonstrated. In a relentless disease such as IPF, striving to optimize HRQOL should complement the endeavour to prolong life. Unfortunately, there is a paucity of interventions improving symptoms and functionality for patients with IPF, and research focusing on symptom improvement, and assessing and optimizing HRQOL, is limited. This review summarizes the most recent insights into measuring and improving quality of life for patients with IPF, and discusses challenges in the management of this devastating disease. Moreover, we postulate a new model for continuous care in IPF - 'the ABCDE of IPF care': Assessing patients' needs; Backing patients by giving information and support; delivering Comfort care by focusing on treating symptoms and taking into account Comorbidities; striving to prolong life by Disease modification; helping and preparing patients and their caregivers for the eventual End-of-life events that are likely to occur.
authors.affiliation: Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, The Netherlands.
authors.forename: Mirjam J G
authors.initials: MJ
authors.lastname: van Manen
authors.affiliation: Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, The Netherlands.
authors.forename: J J Miranda
authors.initials: JJ
authors.lastname: Geelhoed
authors.affiliation: Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, The Netherlands.
authors.forename: Nelleke C
authors.initials: NC
authors.lastname: Tak
authors.affiliation: Department of Respiratory Medicine, Erasmus Medical Center, University Hospital Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Marlies S
authors.initials: MS
authors.lastname: Wijsenbeek
mesh_terms: D003695:Delivery of Health Care / Q000379:methods*; D018450:Disease Progression; D005190:Family / Q000523:psychology; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000503:physiopathology / Q000628:therapy*; D010353:Patient Education as Topic / Q000379:methods; D011379:Prognosis; D011788:Quality of Life; D013727:Terminal Care / Q000379:methods
keywords: health-related quality of life; idiopathic pulmonary fibrosis; pulmonary fibrosis care