Multidisciplinary management of interstitial lung disease in autoimmune rheumatic diseases: an Italian Delphi consensus

Background: Although guidelines recommend a multidisciplinary team (MDT) approach for the diagnosis and management of systemic autoimmune rheumatic disease-associated interstitial lung disease (SARD-ILD), they lack guidance on MDT composition and function. This Delphi consensus project aimed to define a shared MDT model for managing patients with SARD-ILD. Methods: A questionnaire was circulated to an expert panel of 77 Italian pulmonologists, rheumatologists, immunologists, and internal medicine specialists, with statements rated over two voting rounds using a 5-point Likert scale. Results: Response rates were 73% and 95% for the first and second rounds, respectively, after which consensus (≥66.6% agreement) was achieved for all the statements. Consensus statements and recommendations address the responsibilities of healthcare professionals involved in an MDT, including organization, referrals, management, and standard outcomes. Conclusion: Although limited to Italy, the current consensus project is the first attempt to define shared rules for MDTs in the context of SARD-ILD, but further work is needed to achieve international consensus on this topic.