Interstitial Lung Diseases — the Experience in Telenursing

INTRODUCTION: Interstitial lung diseases (ILD) are a group of diseases, the only or the main manifestation of which is a pathological process in the pulmonary interstitium. One of factors of the unfavorable course of chronic forms of ILD is progressing fibrosis of the lung tissue. While idiopathic pulmonary fibrosis is a classic fibrosing ILD with the poorest prognosis, diffuse pulmonary fibrosis can also occur in other ILDs. The progression of the disease leads to restrictive alterations of breathing and to impairment of the diffusion capacity of lungs, which results in respiratory failure, reduced tolerance to physical exercise and disability of the patient. This impedes routing of such patients and limits access to specialized medical care. Restrictive measures introduced in 2020–2021 in connection with a new coronavirus infection, and for elderly people with chronic diseases as well, produced an additional negative impact on the possibility of patients to receive qualified medical care of specialists. In these conditions, the relevance of standard telemedicine healthcare services increased, and there appeared an urgent need for developments of a digital nursing system for chronic patients providing a possibility of active remote communication of a doctor and a patient. This review presents the experience in use of a digital nursing program for monitoring and self-monitoring of chronic non-infectious patients, including those with respiratory diseases. The article presents a clinical case of joint management of a comorbid patient with a severe damage to pulmonary interstitium and the underlying rheumatoid arthritis by pulmonologists and rheumatologists through telenursing. Positive aspects of the remote monitoring are discussed. CONCLUSION: Use of telenursing technology in patients with chronic respiratory diseases may improve clinical effectiveness of treatment of this group of patients as well as reduce the load on the primary healthcare doctors and frequency of untargeted hospitalizations, which, in turn, will reduce the treatment costs.