ILD related to connective tissue diseases (CTD-ILD) is a sub group of ILD, which may have a more positive outcome with the use of immunosuppressive therapies. Historically these patients would be referred to a tertiary centre, but this has an impact on the patient. We aimed to find out if a joint clinic in a district general hospital could provide satisfactory care with similar outcomes.

At our hospital, we established a joint clinic held monthly with the rheumatologist and the respiratory physician reviewing the patients together, following discussion in the ILD multidisciplinary meeting.

We reviewed the outcomes from 2016 to 2019 for 104 consecutive patients, with a mixture of diseases. Mean age was 67 years and 36% were male. 83% were treated with immunosuppressants, including 13% who had biologics. 51% reported improvement in their symptoms. 78% had stable/ improved FVC, 77% stable/improved DLCO, and 60% stable/improved 6 minute walk tests. 67% of patients (n=58) with repeat imaging had stable/improved CT features. As of December 2020, 26% of patients had died, one third as a result of their ILD.

These outcomes support management in a district hospital, with safety netting provided by a multidisciplinary approach, close monitoring and review, and referral onward, if required, to a tertiary centre. Limitations are the retrospective nature of the study and the prolonged timeline, although the latter was also as astrength, as it allowed review of a fairly large cohort of patients. Our study establishes that a combined specialist ILD-Rheumatology clinic can successfully manage these patients, to improve time to treatment, frequency/ ease of monitoring, and patient experience.