RESPTREC: Respiratory Educator and Training Program

Idiopathic Pulmonary Fibrosis Course

In response to the expressed need from the respiratory healthcare community in Canada for a comprehensive educator program in idiopathic pulmonary fibrosis (IPF), RESPTREC® created this online IPF course to join the suite of courses offered by RESPTREC®.

The RESPTREC® IPF course is designed to give respiratory educators the knowledge, skills, and resources needed to help patients and their families learn about IPF and how to better self-manage living with this disease.

Curriculum includes:

  • IPF Education and Self-management
  • IPF Introduction
  • IPF Diagnosis
  • IPF and Comorbidities
  • IPF Mortality Risk
  • IPF Management (subdivided as follows):
    • Comprehensive Overview
    • Pharmacotherapy
    • Acute Exacerbation of IPF
    • Tobacco Cessation
    • Exercise and Physical Activity
    • Pulmonary Rehab
    • Long Term Oxygen Therapy
    • Lung Transplantation
    • Symptom and Advance Care Management
    • Medical Assistance in Dying
    • Monitoring and Follow-up
    • Clinical Trials

CHAPTER: IPF Education and Self-management

  1. Explain IPF Education and Self-management
    1. Describe self-management
    2. Explain the goals of education and self-management
    3. Describe the core skills for successful self-management
    4. Describe the components of IPF education and self-management interventions
      1. Dealing with a diagnosis
      2. Adopting a healthy and fulfilling lifestyle
      3. Treating pulmonary fibrosis
      4. Managing the impact
      5. Using an action plan for worsening symptoms
      6. Engaging in physical activity
      7. Integrating long-term oxygen therapy
      8. Planning for the future (including end of life)
  2. Describe the Living Well With Pulmonary (LWWPF) Fibrosis Program
    1. Explain the goal and objectives of the LWWPF program
    2. Utilize LWWPF resources to support IPF patient education and self-management
  3. Implement a self-management program
    1. Establish a collaborative relationship among patient-family-practitioners
    2. Collaborate with the patient/family to develop a self-management plan
    3. Counsel the patient/family on self-management plan
    4. Explain the role of support groups in helping patients and families self-manage, including where in Canada support groups for IPF exist

CHAPTER: Introduction to Idiopathic Pulmonary Fibrosis (IPF)

  1. Define IPF
    1. Describe Pulmonary Fibrosis
    2. Describe Pulmonary Fibrosis in terms of known and unknown causes including:
      1. Known
        1. Iatrogenic
        2. Occupational and organic exposures
        3. Autoimmune disease
      2. Unknown
        1. Idiopathic pulmonary fibrosis (most common)
    3. Describe Idiopathic Pulmonary Fibrosis (IPF)
  2. Examine the epidemiology of IPF
    1. Describe the morbidity and mortality of IPF in Canada in terms of:
      1. Incidence and prevalence of IPF in Canada
      2. Mortality rates
    2. Explain the burden of IPF in terms of:
      1. Economic
      2. Social
  3. Describe the risk factors that influence the development of IPF
    1. Explain the natural (known) history of IPF
    2. Explain the association of the following risk factors in the development of IPF:
      1. Cigarette smoking
      2. Age
      3. Gender
      4. Environmental exposures
      5. Microbial agents
      6. Gastroesophageal Reflux
      7. Genetic

CHAPTER: IPF Diagnosis

  1. Explain factors to consider when making a diagnosis of IPF
    1. Discuss key clinical, radiologic, and histopathologic features in the diagnosis of IPF including:
      1. Clinical:
        1. Characteristic symptoms
        2. Physical examination
        3. Pulmonary function testing
      2. Radiologic:
        1. Presence of usual interstitial pneumonia (UIP) pattern on high resolution computed tomography (HRCT)
      3. Histopathologic:
        1. Surgical lung biopsy
      4. Differential diagnosis (exclusion of other known causes of pulmonary fibrosis)

CHAPTER: IPF and Comorbidities

  1. Explain the common comorbidities that can coexist with IPF
    1. Discuss the clinical impact of comorbidities including:
      1. Emphysema
      2. Lung Cancer
      3. Pulmonary Hypertension
      4. Venous Thromboembolism
      5. Sleep-disordered Breathing
      6. Gastroesophageal Reflux Disease
      7. Coronary Artery Disease
      8. Depression/Anxiety
      9. Diabetes
      10. Deconditioning
    2. Discuss management considerations for comorbidities that can coexist with IPF

CHAPTER: IPF Mortality Risk

  1. Discuss IPF mortality risk
    1. Examine the evidence around the predictors of survival in IPF including:
      1. Clinical predictors
      2. Radiographic predictors
      3. Physiologic predictors
      4. Pathologic predictors
      5. Biomarker predictors

CHAPTER: IPF Management: Comprehensive Overview

  1. Discuss the comprehensive management of IPF (Overview)
    1. Explain the following pillars of care as they relate to the comprehensive management of IPF:
      1. Disease-centered management
      2. Symptom-centered management
      3. Education and self-management

CHAPTER: IPF Management: Pharmacotherapy

  1. Discuss the approved pharmacological treatments for IPF
    1. Discuss the recommendation regarding the approved pharmacotherapy options for IPF
    2. Explain the following pharmacotherapy agents:
      1. Pirfenidone; and
      2. Nintedanib; in terms of:
        1. Type of medication
        2. Action of the medication
        3. Indications and clinical use
        4. Medications available in Canada
        5. Contraindications
        6. Adverse reactions

CHAPTER: IPF Management: Acute Exacerbation of Idiopathic Pulmonary Fibrosis (AEIPF)

  1. Discuss Acute Exacerbation of Idiopathic Pulmonary Fibrosis (AEIPF)
    1. Explain the following as it relates to AEIPF:
      1. Definition
      2. Epidemiology
      3. Etiology
      4. Risk factors
      5. Prognosis/impact
      6. Assessment and differential diagnosis
    2. Discuss the existing evidence on the management of AEIPF including:
      1. Pharmacological therapy
      2. Non-pharmacological therapy
    3. Identify potential reasons for deterioration
    4. Discuss an action plan as a self-management tool including:
      1. What an action plan is
      2. How to use an action plan

CHAPTER: IPF Management: Tobacco Cessation

  1. Discuss approved tobacco cessation approaches
    1. Describe nicotine addiction and withdrawal
    2. Discuss the Canadian trends in tobacco use
    3. Describe the benefits of tobacco cessation for patients with IPF
    4. Describe the levels of tobacco cessation interventions, for example:
      1. Self-directed
      2. Brief
      3. Intensive
    5. Describe the following brief intervention approaches:
      1. 5 As
      2. Very brief advice (VBA)
    6. Discuss the following tools to assess readiness to change and nicotine dependence:
      1. Readiness Ruler/Fagerstrom Test for Nicotine Dependence (FTND)
      2. Heaviness of Smoking Index (HIS)
    7. Describe models of behaviour change and motivational communication including:
      1. Transtheoretical Model
      2. Health Belief Model
      3. Confidence and Conviction Model
      4. Motivational Interviewing
    8. Develop a quit plan for tobacco
    9. Discuss pharmacotherapy options for tobacco cessation
    10. Identify tobacco cessation resources including counselling services available in the patient's community

CHAPTER: IPF Management - Exercise and Physical Activity

  1. Discuss exercise and physical activity as a part of a healthy lifestyle for patients with IPF
    1. Discuss the important exercise and physical activity limitations observed in IPF
    2. Explain the benefits of exercise and physical activity
    3. Discuss the key counselling considerations on increasing physical activity for a patient with IPF including:
      1. The importance of increasing physical activity
      2. Recommendations for physical activity
      3. How to monitor the intensity of physical activity
      4. Normal and abnormal symptoms that can be present during physical activity
    4. Discuss the resources available to support exercise and promote physical activity for patients with IPF

CHAPTER: IPF Management - Pulmonary Rehabilitation (PR)

  1. Discuss Pulmonary Rehabilitation (PR) for IPF
    1. Describe PR
    2. Explain the benefits of PR
    3. Discuss the selection criteria for PR (who to refer)
    4. Describe the components of PR:
      1. Exercise
      2. Education and self-management
    5. Discuss the current trends in PR in Canada with respect to:
      1. Access
      2. Models of PR program delivery
    6. Identify PR services in the patient’s community

CHAPTER: IPF Management - Long Term Oxygen Therapy

  1. Discuss Long Term Oxygen Therapy (LTOT)
    1. Dicuss hypoxemia and its effects
    2. Explain the rationale for LTOT
    3. Discuss the evidence for LTOT in IPF
    4. Discuss the assessment for LTOT
    5. Explain the recommendations for LTOT in IPF
    6. Explain who can prescribe oxygen therapy in Canada
    7. Describe oxygen delivery systems and devices in terms of:
      1. Application
      2. Advantages
      3. Limitations
    8. Explain the counselling considerations for LTOT for IPF patients in terms of:
      1. General considerations
      2. Safety considerations
      3. Travel considerations
    9. Identify LTOT services in the patient’s community

CHAPTER: IPF Management - Lung Transplantation

  1. Explain lung transplantation for IPF
    1. Discuss lung transplantation for IPF in terms of:
      1. Recipient selection
      2. Resources available for patients and professionals

CHAPTER: IPF Management - Symptom and Advance Care Management

  1. Discuss additional considerations for symptom and advance care management in IPF
    1. Describe what palliative care is and how these services may be used in the management of IPF
    2. Explain symptom-centred management in IPF
    3. Explain the role of Advance Care Planning (ACP) in IPF including:
      1. Goals of care
      2. Advance directives (ADs)
      3. Power of attorney
    4. Explain what may be included in end-of-life care for patients with IPF
    5. Identify palliative and hospice care services in the patient’s community

CHAPTER: IPF Management - Medical Assistance in Dying

  1. Discuss medical assistance in dying (MAiD) in Canada
    1. Explain where to find information related to MAiD in Canada including:
      1. Canadian legislation
      2. Who is eligible
      3. Who can provide assistance
      4. Process for requesting service
      5. Where and how services are provided

CHAPTER: IPF Management - Monitoring and Follow-up

  1. Discuss the importance of monitoring and follow-up for IPF patients
    1. Explain the importance of monitoring and follow up in IPF in terms of:
      1. Monitoring for progressive disease
      2. Monitoring for worsening symptoms
      3. Monitoring for worsening oxygenation
      4. Monitoring for complications and multimorbidities

CHAPTER: IPF Management - Clinical Trials

  1. Discuss the clinical trials currently available in Canada for IPF
    1. Explain the role and importance of clinical trials in IPF
    2. Explain how IPF patients can become involved in clinical trials in Canada

Participants must meet the following entrance criteria:

  • hold a degree/diploma in a recognized health care profession and work in the health care field

If there is a question regarding met criteria, acceptance to the program will be made on an individual basis and at the discretion of the RESPTREC® Management committee.

A wide range of representatives from health disciplines and endorsing agencies were involved in the development of this course including: the Canadian Thoracic Society (CTS - COPD Clinical Assembly and authors of guidelines and publications), Canadian Respiratory Health Professionals (CRHP), Family Physician's Airways Group of Canada (FPAGC), The Lung Association, clinicians, researchers, certified respiratory educators, pharmacy, respiratory therapy, nursing and physical therapy.

RESPTREC® would like to acknowledge the extraordinary contribution the following individuals of the IPF Course Expert committee and additional contributors made to the development of this course.

Idiopathic Pulmonary Fibrosis Course Expert Committee

  • Charlene Fell, MD, MSc, FRCPC, FCCP
    • Representing the Canadian Thoracic Society (CTS)
  • Pat Popwell, RN, BN, RCPT(P), CRE
    • Representing Canadian Respiratory Health Professionals (CRHP)
  • Alan Kaplan, MD, CCFP(EM), FCFP (FPAC)
    • Representing Family Physician’s Airways Group of Canada (FPAGC)
  • Jill Hubick, BKin, BSN, RN, CRE
  • Trent Litzenberger, BScPT, BSPE, CRE
  • Kirk Mathison, RN
  • Jan Neumann, BPT, CRE
  • Noel Pendergast, MPH, BPEd, RRT, CRE
  • Chris Ryerson, MD, FRCPC
  • Maria Sedeno, MM
    • Representing RESPIPLUS
  • Lori Nagy, Administrative support
  • Additional contributors include:
    • Lana Biro, RRT, CRE
    • Barb Evans, BSP, ACPR, MSc, FCSHP
    • Mark Fenton, MD, FRCPC
    • Lisa Wickerson, BScPT, MSc

RESPTREC® gratefully acknowledges Boehringer Ingelheim Canada Ltd and Hoffman-La Roche Ltd for providing support for the development of the IPF course through unrestricted education grants.

The hours invested in completing this course can be included in your continuing professional education learning portfolio. There are currently no accredited study credits allocated to this course.

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Saskatoon, SK  S7J 3L3

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