# Comparison of Palliative Care Models in Idiopathic Pulmonary Fibrosis
## 3 Results
### Palliative Care Delivery  
Increased Symptom Management and ACP  
Overall, 63% (188) received PC as per study definition: 98% (93) in EC, 94% (79) in BC, and 13% (16) in QC (\(p\) < 0.001; Table 2). Twenty percent were referred to specialist PC (3% EC, 20% BC, and 21% QC). Additionally, in BC cohort, 54% (45) were discussed \begin{table}
\begin{tabular}{l c c c c} \hline \hline
**Patient Profile at Baseline** & **All Cohorts (\(\pi\) = 298)** & **EC (\(\pi\) = 95)** & **BC (\(\pi\) = 84)** & **QC (\(\pi\) = 119)** \\ \hline Age, years (median, IQR) & Median: 71 (IQR 67–78) & Median: 71 (IQR 65–76) & Median: 74 (IQR 68–78) & Median: 74 (IQR 68–79) \\ Gender (\%) & M: 73.8\% (220), F: 26.1\% (78) & 65.3\% in (62), 34.7\% \& (33) & 85.7\% m (72), 14.3\% f (12) & 72.3\% M (86), 27.7\% F (33) \\ BMI (median, IQR) & 28.3, 25.5\%-32.0 & 29.0, 26.0–33.3 & 26.4, 246.-28.7 & 29.9, 26.5–32.2 \\ CCI (median, IQR) & 4.3, & 3.3 & 4, 3-5 & 4, 3-5 \\ Ever smoker (\%) & 78.1\% (225/288) & 82.0\% (73/89) & 77.1\% (64/83) & 75.9\% (88/116) \\ Dyspnea (Y/N \%) & 97.0\% (289/298) & 95.8\% (91/95) & 96.4\% (81/84) & 98.3\% (117/119) \\ MRC score (median, IQR) & 3, 2-4 & 3, 2-4 & 3, 2-4 & 2, 2-4 \\ Cough (Y/N \%) & 81.6\% (239/293) & 79.8\% (75/94) & 75.9\% (63/83) & 87.1\% (101/116) \\ Fatigue (Y/N \%) & 32.1\% (86/268) & 52.9\% (37/70) & 27.2\% (22/81) & 23.1\% (27/117) \\ \% pref PVC & 73\%, 61–85\% & 73\%, 63–83\% & 69\%, 57–80\% & 81\%, 70–92\% \\ (median, IQR) & 10.1\% (28/278) & 9.20\% (8/87) & 13.1\% (11/84) & 8.41\% (9/107) \\ FVC \(\leq\) 50\% & & & & \\ \% pred DLCO adj for Hg & 48\%, 39–61\% & 47\%, 38–59\% & 38\%, 30–46\% & 54\%, 45–67\% \\ FVC (median, IQR) & 16.5\% (40/243) & 20.5\% (15/73) & 30.4\% (21/69) & 3.96\% (4/101) \\
6 MWD, m (median, IQR) & 330, 240–424 & 328, 210–445 & 260, 200–340 & 384, 314–456 \\ Nadir \% SpO2 & 87\%, 82–91\% & 84\%, 80–88\% & 85\%, 82–89\% & 91\%, 85–95\% \\ (median, IQR) & 36.8\% (102/277) & 36.8\% (32/87) & 23.8\% (20/84) & 47.2\% (50/106) \\ GAP Stage II & 43.3\% (120/277) & 41.4\% (36/87) & 45.2\% (38/84) & 43.4\% (46/106) \\ GAP Stage III & 19.9\% (55/277) & 21.8\% (19/87) & 30.9\% (26/84) & 9.43\% (10/106) \\ Antibrothers (\%) & 39.5\% (110/298) & 24.2\% (23/95) & 31.0\% (26/84) & 58.0\% (69/119) \\ Anti-acid medications & 58.8\% (174/296) & 66.3\% (63/95) & 47.6\% (40/84) & 60.7\% (71/117) \\ NAC (\%) & 9.06\% (27/296) & 3.16\% (3/95) & 4.7\% (4/84) & 17.1\% (20/117) \\ NIV (CAP/Bipap) & 4.62\% (12/260) & 19.3\% (11/57) & 1.19\% (1/84) & 0 \\ Transplant & 1 t, 9 listed & 0 t, 6 listed & 1 t, 1 listed & 0 t, 2 listed \\ \hline \hline \end{tabular}  
* CCI: Charlson Comorbidity Index; MRC: medical research council; PPI; proton pump inhibitor; NAC: N-acetyl cysteine; NIV: non-invasive ventilation; CPAP: continuous positive airway pressure; and BiPAP; bi-level positive airway pressure.  
\end{table} 
Table 1: Demographics. in Palliative-ILD-Psychology (PIP) multidisciplinary team meetings where specialist PC advice was received. In QC, 21% of patients were referred to the specialist PC clinic based on criteria described but only 13% received PC based on study criteria. Significant differences were noted across cohorts. High rates of non-pharmacologic dyspnea strategies (pacing or energy conversation) were used in EC (98%) and BC (94%) in contrast to 2% recorded in QC (_p_ < 0.001). In the QC cohort, non-pharmacologic management of dyspnea (and other symptoms) was routinely addressed at each PC visit but not documented. Similarly, higher rates of oxygen use noted in EC (71%) and BC (87%) compared to 24% in QC (_p_ < 0.001). Forty-five percent of EC and BC patients were on opiates for dyspnea and 23% of QC (_p_ < 0.001) (Table 2, Figure 1A). Data from patients seen in the QC specialist PC clinic are analyzed separately in Supplement Table S4. Significant differences were also noted in ACP practices across cohorts. Communication regarding disease, prognosis and planning was initiated in 98% EC and 100% BC patients compared to 5% in QC at first ILD visit (_p_ < 0.001) (Table 2).