Consensus statement on the management of pulmonary hypertension in clinical practice in the UK and Ireland
Produced by the National Pulmonary Hypertension Centres of the UK and Ireland
Thorax 2008;63(Suppl II):ii1–ii41. doi:10.1136/thx.2007.090480
Download the statement here.
Five centres have been recently designated by NSCAG to provide pulmonary hypertension services as part of a National Pulmonary Hypertension Services Network for England and Wales.
The Network offers treatment to patients with primary pulmonary hypertension; hypertension complicating other diseases such as systemic sclerosis, HIV or cirrhosis, chronic thromboembolic disease; and pulmonary hypertension complicating cardiac disease. The five centres are:-
- Great Ormond Street, Hammersmith, Royal Brompton and Royal Free Hospitals, London
- Freeman Hospital, Newcastle
- Royal Hallamshire Hospital, Sheffield
- Papworth Hospital, Cambridge
- Wythenshawe Hospital, Manchester
- In addition, the West Glasgow Hospital offers this service in Scotland.
A service specification, including standards of care, has been agreed and each centre will be measured against these standards on a regular basis. Recent guidelines for the management of such patients have been published. These include recommendations for the use of intravenous eporostenol (prostacyclin) and iloprost. There is a large body of evidence demonstrating clinical effectiveness of such therapy on both quality and quantity of life in such patients (reference Heart 2001:86(suppl 1); i1-i13).
Many patients with severe pulmonary hypertension present relatively late in the course of their disease and without treatment death is likely to occur in a relatively short space of time. As a consequence it is important that there are no major delays in initiating therapy. Commissioners are asked to facilitate swift referral of patients to one of the designated centres. Becasue of the low volume, high cost nature of this service, commissioners may want to consider setting up risk sharing consortia.