10 January, 2013

NICE Consults on New Idiopathic Pulmonary Fibrosis Draft Guidance

The National Institute for Health and Clinical Excellence (NICE) is currently developing a clinical guideline on the management of idiopathic pulmonary fibrosis. As part of this process,draft recommendations have been published on the NICE website today (11 January) for consultation.

Idiopathic pulmonary fibrosis is a chronic, progressive disease associated with scarring of the lungs. Most people with the condition experience symptoms of breathlessness, and a cough which both lead to the decline of lung function, reduced quality of life and ultimately death. Each year around 4,000 adults in the UK are diagnosed with idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis is relatively rare and can be mistaken for other diseases. This draft clinical guidance recommends that healthcare professionals, particularly GPs, should be aware of the clinical features of the condition to ensure patients have access to chest X-rays and specialist referrals. Health professionals should look out for key signs and symptoms, such as, breathlessness, persistent cough, respiratory crackles when listening to the chest and clubbing of the fingers.

Once idiopathic pulmonary fibrosis is suspected, the NICE draft guideline recommends a diagnosis should only be made with the consensus of a multidisciplinary team, including always a chest physician, a radiologist and a specialist nurse, and that diagnosis should be based on a patient's clinical features, lung function and radiological findings, with the addition of pathology when indicated.

NICE also provisionally recommends that at the time of diagnosis, people are assessed for pulmonary rehabilitation[1]. It goes on to say that pulmonary rehabilitation should be tailored to each individual's needs and can improve the well-being and quality of life for people with chronic breathing problems.

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: "Idiopathic pulmonary fibrosis is a chronic condition that significantly effects a person's life. After initial symptoms, a person's condition can decline rapidly, so it is vital that people have access to a timely diagnosis and access to the correct treatments and therapeutic interventions. There are no known causes of this chronic progressive condition, so healthcare professionals must be aware of the signs to be able to provide supportive care that can improve a person's quality of life.

"We would urge all those registered as stakeholders in the development of this guideline to have their say on our draft recommendations, and submit their comments via the NICE website."

The draft consultation runs from Friday 11 January 2013 to Friday 22 February 2013.


About the clinical guideline

1. The draft guideline is available for consultation on the NICE website from Friday 11 January 2013 at:http://guidance.nice.org.uk/CG/Wave24/5.

2. Only stakeholders can comment formally on consultations, but organisations can register throughout the development process and contribute from that point onward. For more information please visit: http://www.nice.org.uk/getinvolved/sh/cg/shregistration.jsp

3. The final guideline is expected to be published in June 2013

About NICE

4. The National Institute for Health and Clinical Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health

5. NICE produces guidance in three areas of health:

  • public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
  • health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
  • clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS

6. NICE produces standards for patient care:

  • quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
  • Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients

7. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates and accredits high quality health guidance, research and information to help health professionals deliver the best patient care through NHS Evidence.

[1] Pulmonary rehabilitation is an exercise and educational programme designed to help patients with limiting symptoms due to respiratory conditions such as COPD. The aim of pulmonary rehabilitation is to improve patients' exercise tolerance and functional independence.