General Rules for Treatment of a Chronic Condition from the International Consensus Guidelines for the Therapy of Idiopathic Pulmonary Fibrosis

Description

The American Thoracic Society (ATS) and the European Respiratory Society (ERS) issued guidance for therapy in patients with idiopathic pulmonary fibrosis. These can serve as general rules for the therapy of other chronic diseases with a progressive course.

The first step is to decide the time interval in weeks for a positive response to therapy to be evident.

The patient is evaluated at twice the time for a response.

Patient's Condition	Action
worse	stop or change therapy
stable or improved	continue therapy using the same doses

If the therapy is continued, then the patient is evaluated at twice the time for a response (at four times the time for a response from initiating therapy).

Patient's Condition	Action
worse	stop or change therapy
stable or improved	continue therapy using the same doses

If the therapy is continued, then the patient is evaluated at twice the time for a response (at six times the time for a response from initiating therapy).

Patient's Condition	Action
objective evidence of benefit (stable or improved)	continue therapy indefinitely
else	individualize the therapy based on the patient's response tolerance to therapy

These rules can be modified to take into account the adverse effects. For example, if a person has had a favorable response with some adverse events, the regimen may be reduced. Alternatively, if the patient has had some evidence of response but no signs of adverse events, then the doses could be increased.

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Description

Specialty

ICD-10