Cystic fibrosis

Emergency referrals

If any of the following are present or suspected, refer the patient to the emergency department (via ambulance if necessary).

Cystic fibrosis with any of the following concerning features:

  • respiratory distress
  • new haemoptysis (clots or more than streaks)
  • pleural effusion
  • consolidation/pneumonia/fever
  • non- response to antibiotics for chest infection

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • Newly diagnosed cystic fibrosis
  • Patients with known cystic fibrosis transitioning from a paediatric or other adult centre who have recent clinical instability and/or severe lung disease (FEV1<40%)

Category 2

Appointment within 90 days is desirable

  • Suspected but undiagnosed cystic fibrosis
  • Patients with known cystic fibrosis transitioning from a paediatric or other adult centre who have recent clinical stability or moderate lung disease (FEV1>40%)

Category 3

Appointment within 365 days is desirable

  • No category 3 criteria

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Other important information for referring practitioners

Not an exhaustive list

  • Refer to HealthPathways for assessment and management information if available
  • All patients diagnosed with cystic fibrosis should be managed by a cystic fibrosis service in a tertiary facility

Referral requirements

A referral may be rejected without the following information.

  • Medications
  • Symptoms including:
    • duration
    • severity
    • non- pulmonary CF problems
    • recent admissions
  • Previous centre of care (if transitioning patient)

Additional referral information (Useful for processing the referral)

  • Calcium, vitamin D, coagulation profile, fasting glucose, fat soluble vitamin levels and iron study results
  • Spirometry
  • Family history
  • FBC, ELFT results
  • CXR/CT and any other relevant imaging
  • Any recent sputum culture results
  • Genotype
  • Weight history/trend
  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary
  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)