Patient perspectives on the use of indwelling pleural catheters in malignant pleural effusions.


Journal

Thorax
ISSN: 1468-3296
Titre abrégé: Thorax
Pays: England
ID NLM: 0417353

Informations de publication

Date de publication:
11 2023
Historique:
received: 21 07 2022
accepted: 07 04 2023
medline: 23 10 2023
pubmed: 13 5 2023
entrez: 12 5 2023
Statut: ppublish

Résumé

Indwelling pleural catheters are an effective treatment option for patients with malignant pleural effusions. Despite their popularity, there remains a paucity of data on the patient experience and key patient-centred outcomes. To investigate the experience of patients receiving an indwelling pleural catheter to better inform and identify potential areas for improvement in care. This was a multicentre survey study at three academic, tertiary-care centres in Canada. Patients with a diagnosis of malignant pleural effusion who had an indwelling pleural catheter inserted were included. An adapted questionnaire specific to indwelling pleural catheters was used with responses recorded on a 4-point Likert scale. Patients completed the questionnaire in-person or by phone at 2-week and 3-month follow-up appointments. A total of 105 patients were enrolled in the study with 84 patients included in the final analysis. At the 2-week follow-up, patient-reported improvements in dyspnoea and quality of life from indwelling pleural catheter were high at 93% and 87%, respectively. The predominant issues identified were discomfort at time of insertion (58%), itching (49%), difficulty with sleeping (39%), discomfort with home drainage (36%) and the pleural catheter reminding patients of their disease (63%). Avoiding hospitalisation for the management of dyspnoea was important to 95% of patients. Findings were similar at 3 months. Indwelling pleural catheters are an effective intervention to directly improve dyspnoea and quality of life but have important disadvantages for some; clinicians and patients should be aware of these when making an informed decision regarding treatment.

Sections du résumé

BACKGROUND
Indwelling pleural catheters are an effective treatment option for patients with malignant pleural effusions. Despite their popularity, there remains a paucity of data on the patient experience and key patient-centred outcomes.
OBJECTIVE
To investigate the experience of patients receiving an indwelling pleural catheter to better inform and identify potential areas for improvement in care.
METHODS
This was a multicentre survey study at three academic, tertiary-care centres in Canada. Patients with a diagnosis of malignant pleural effusion who had an indwelling pleural catheter inserted were included. An adapted questionnaire specific to indwelling pleural catheters was used with responses recorded on a 4-point Likert scale. Patients completed the questionnaire in-person or by phone at 2-week and 3-month follow-up appointments.
RESULTS
A total of 105 patients were enrolled in the study with 84 patients included in the final analysis. At the 2-week follow-up, patient-reported improvements in dyspnoea and quality of life from indwelling pleural catheter were high at 93% and 87%, respectively. The predominant issues identified were discomfort at time of insertion (58%), itching (49%), difficulty with sleeping (39%), discomfort with home drainage (36%) and the pleural catheter reminding patients of their disease (63%). Avoiding hospitalisation for the management of dyspnoea was important to 95% of patients. Findings were similar at 3 months.
CONCLUSIONS
Indwelling pleural catheters are an effective intervention to directly improve dyspnoea and quality of life but have important disadvantages for some; clinicians and patients should be aware of these when making an informed decision regarding treatment.

Identifiants

pubmed: 37173137
pii: thorax-2022-219449
doi: 10.1136/thorax-2022-219449
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1111-1117

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Michael A Mitchell (MA)

Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada MichaelA.Mitchell@lhsc.on.ca.

Emilie Deschner (E)

Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Inderdeep Dhaliwal (I)

Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Michael Robinson (M)

Faculty of Health Sciences, Western University, London, Ontario, Canada.

Pen Li (P)

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Chanel Kwok (C)

Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Lorraine Cake (L)

Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Emily Dawson (E)

Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

James Veenstra (J)

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Daniel Stollery (D)

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Ashley-Mae Gillson (AM)

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

Kayvan Amjadi (K)

Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

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