Interstitial lung disease (ILD) Referral Access Criteria

Referrers should use this page when referring patients to public adult respiratory and sleep medicine outpatient services for interstitial lung disease.
Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
  • Suspected acute exacerbation of ILD (infected or non-infected) manifest by significant increase in symptoms compared to baseline or evidence of acute desaturations compared to normal baseline
  • New right heart failure in association with an acute deterioration.
  • Acute ILD drug toxicity (e.g. jaundice, deranged LFT) or severe intolerance
Immediate referral
Orange exclamation mark in triangle: orange alertImmediately contact on-call registrar or service to arrange immediate respiratory assessment (seen within 7 days):
  • Nil

To contact the relevant service, see Clinician Assist WA: Acute Respiratory assessment (external site).

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
  • Any of the following symptoms in conjunction with an abnormal CT consistent with ILD:
    • Cough
    • Dyspnoea that limits ADLs
    • Fatigue
    • Reduced SpO2 at rest
    • Cyanosis
Mandatory information

Referrals missing 'mandatory information' with no explanation provided may not be accepted by site. If 'mandatory information' is not included, the explanation must be provided in the body of the referral (e.g. patient unable to access test in regional or remote areas or due to financial reason).

This information is required to inform accurate and timely triage. If unable to attach reports, please include relevant information/findings in the body of the referral and advise where (provider) investigation/imaging was completed.

 

History
  • Relevant history, onset, duration, and severity of symptoms including dyspnoea
  • Details of previous treatment and outcome (including previously trialled medication if associated with treatment failure or problems)
  • Relevant past medical history (particularly connective tissue disorders)
  • Current medication list
  • Any known allergies
  • Occupational history/asbestos exposure
  • Degree of functional impairment (e.g. impact on exercise tolerance/ADLs/ability to work)
  • Smoking/vaping status and history
Examination
  • Resting SpO2
  • Bilateral crepitations on auscultation
Investigations 
  • High resolution CT chest (report must be included)
  • Lung biopsy report (if previously performed)
Highly desirable
History
  • Nil

Examination
  • Nil
Investigations
  • Previous lung function tests
  • FBC (including WCC differential)
  • Auto-antibody screen
Indicative clinical urgency category

Category 1

Appointment within 30 days

  • Newly diagnosed or suspected ILD with radiographic evidence with Grade 4 dyspnoea (ADLs affected by dyspnoea) (external site)
  • Newly diagnosed or suspected ILD with Grade 2/3 dyspnoea (external site)
  • Known ILD with worsening hypoxemia or right heart failure

Category 2

Appointment within 90 days

  • Chronic ILD with Grade 1 dyspnoea (external site)
  • Newly diagnosed or suspected ILD without symptoms

Category 3

Appointment within 365 days

  •  Known ILD with stable symptoms requiring specialist opinion
Exclusions
  • Nil
Useful information

Clinician resources

  • Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease: The COPD-X Plan (external site)

Feedback

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Last reviewed: 16-08-2024