P129 Interdisciplinary collaboration in the care of patients with connective tissue disease-related interstitial lung disease in Wales: an interview study

Abstract

Abstract Background/Aims Patients with connective tissue disease-related interstitial lung disease (CTD-ILD) often receive care from both rheumatologists and respiratory physicians to manage their conditions. As treatment options become increasingly complex with immunosuppressing and antifibrotic agents, there is a growing recognition of the importance of collaborative approaches to ensure accurate diagnosis, aid management decisions and deliver patient-centred care. However, there is currently no agreed optimal model for shared care, leading to significant practice variation. This study aimed to explore the perspectives of rheumatologists and respiratory physicians regarding the benefits and challenges of cross-speciality management in CTD-ILD. A better understanding of this will enhance the development of services and improve patient-centred care. Methods Semi-structured interviews, both face-to-face and virtual, were conducted with 11 respiratory physicians and nine rheumatologists working in Wales, ensuring representation from all health boards. Interview transcripts were analysed using thematic analysis to identify themes. Results Five main themes were identified: navigating complexity and uncertainty, reliance on clinical experience, prioritisation of efficiency, educational and training benefits, and inconsistent access to services for clinicians and patients. Conclusion The complexity of CTD-ILD care, combined with varying levels of physician expertise and a perceived lack of guidelines, presents significant challenges for clinicians. Cross-speciality collaboration is actively sought by physicians and is perceived to enhance patient care by improving efficiency, aiding confidence in decision-making and providing educational benefits to clinicians. However, resource limitations and geographical variations in service access hinder the implementation and development of shared care models. Physicians perceive that patients like being seen in joint clinics; future exploration of patient perspectives and experiences of joint care systems will be crucial to ensure the direction of clinical practice development remains patient-centred. In addition to implementing integrated cross-speciality clinical services, the development of joint respiratory and rheumatology guidelines as well as greater availability of training opportunities would assist physicians in delivering optimal care to patients with CTD-ILD. Disclosure P. Evans: None. K. Hett: None. N. Hutchinson: None. C. Beynon: None.