Holistic Management of Pulmonary Fibrosis: A Comprehensive Review.

Inés Palacio, Fernanda Hernández-González, Jacobo Sellarés, Jaume Bordas-Martinez

Journal: Medicina (Kaunas, Lithuania) 2026;62(5):

PMID: 42195070

Abstract

Pulmonary fibrosis, encompassing idiopathic pulmonary fibrosis (IPF) and other fibrosing interstitial lung diseases (ILDs) with a progressive phenotype (PPF), represents a group of chronic, life-threatening conditions associated with significant morbidity, mortality, and socioeconomic burden. Despite advances in antifibrotic therapies, traditional disease-centered management alone is insufficient to address the multidimensional needs of affected patients. This comprehensive review advocates for a holistic, patient-centered approach to the management of pulmonary fibrosis, integrating pharmacological interventions with systematic comorbidity assessment, pulmonary rehabilitation, psychosocial support, nutritional optimization, early palliative care, social and community reinforcement, and digital health technologies. We examine the evidence supporting each dimension of holistic care, discuss current barriers to implementation-including healthcare fragmentation, limited multidisciplinary protocols, and scarce resources-and outline future perspectives centered on precision medicine and integrated care models. By shifting from a purely organ-focused paradigm to a comprehensive, multidisciplinary strategy, clinicians can improve not only disease outcomes but also quality of life and overall well-being for patients living with fibrosing ILDs.

Address: Pulmonology Department, Hospital Clinic, 08402 Barcelona, Spain.; Pulmonology Department, Hospital General de Granollers, 08402 Barcelona, Spain.
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