Why Patient Wishes Should Guide IPF Care Decisions: Laura Fabbri, MD

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Fibrotic interstitial lung diseases, like idiopathic pulmonary fibrosis (IPF), commonly overlap with lung cancer—a key talking point at the European Respiratory Society (ERS) 2026 International Congress in Barcelona, Spain.

There, clinicians discussed management decisions and care pathways that incorporate shared decision-making for patients, increasing awareness of the IPF and lung cancer overlap, and better informing future therapeutic trials. Introducing shared decision-making into a complex, multidisease treatment like IPF often poses challenges for clinicians, but Laura Fabbri, MD, from Imperial College London and a speaker at ERS, said in an interview with The American Journal of Managed Care^® that the patient's wishes and desires should still take precedence.

“One is select caliber for the specific person. Do you want a treatment? Do you think this will benefit you, or are you worried or a bit scared about the possible consequences or complications of it?” she explained. “The second part, if you move a bit more into a broader scale, is the fact that we should incorporate more of of what the patient desires or wishes.”

Sometimes, Fabbri explained, patients' quality-of-life outcomes may not factor into clinical trial design. Yet this example further supports the need for shared decision-making, as some trials fail to meet their primary outcome, like forced vital capacity (FVC), even though that outcome may not necessarily matter to the patients.

“Maybe that person doesn't really care about an FVC; they just want to make sure now that his quality of life is still preserved,” she said.

Furthermore, external patient support from family, friends, and community also varies when comparing the experiences and resources available to patients with IPF versus patients with oncological diseases.

“I wouldn't say that the new diagnoses add an extra burden to them just because there is less support with that,” Fabbri explained. “And maybe actually may empower them or may open to them some pathways that before were not available, regardless of psychological support specifically.”