Clinical impact of an interstitial lung disease Nurse on patients with idiopathic pulmonary fibrosis

Background: Idiopathic pulmonary fibrosis (IPF) is fatal chronic, progressive fibrosing, irreversible interstitial pneumonia of unknown cause. Studies have proposed a beneficial role of an interstitial lung disease (ILD) Nurse in IPF management. However, there are no studies assessing the impact of ILD Nurse in IPF. Objective: To assess the impact of an ILD Nurse on hospital admissions and emergency department (ED) visits in patients with IPF. Methods: We included all incident cases of IPF diagnosed in our ILD Clinic between May, 2013 and December, 2016 and compared the hospital admissions/ED rates 20 months before and after our ILD Nurse was hired. Logistic regression was used to adjust for potential confounders. Results: We included 59 patients with IPF. Before the ILD nurse was hired 18/34 (53%) patients had at least one hospital admissions/ED visits, compared to 6/25 (24%) after the ILD nurse (OR: 0.281; p-value=0.025). After adjusting for age, gender, FVC, anti-fibrotic treatment, Charlson comorbidity index and Marital status, having an ILD nurse was associated with a significant reduction in the risk of hospital admissions/ED visits (OR: 0.232; p-value=0.019). Low FVC was associated with increased risk of hospital admissions/ED visits (OR: 1.033; p- value 0.047). None of the other variables was associated with hospital admissions/ED visits. Conclusions: Having an ILD nurse significantly decreased the rate of hospital admissions and ED visits.