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deliver a palliative approach in IPF. Multidisciplinary collaborative teams within such models can address the high burden of unmet needs for symptom management, advance care planning (ACP) and community support in this complex population.RATIONALE The ZZ-genotype of α1-antitrypsin deficiency (AATD) is associated with COPD, even amongst never-smokers. The SZ-genotype is also considered severe, yet its effect on lung health remains unclear. OBJECTIVES To determine the effect of SZ-AATD on spirometry compared to a normal-risk population