The impact of outpatient vs inpatient management on health-related quality of life outcomes for patients with malignant pleural effusion - the OPTIMUM randomized clinical trial.


Journal

The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460

Informations de publication

Date de publication:
23 Nov 2023
Historique:
received: 14 06 2022
accepted: 21 10 2023
medline: 24 11 2023
pubmed: 24 11 2023
entrez: 23 11 2023
Statut: aheadofprint

Résumé

The principal aim of malignant pleural effusion (MPE) management is to improve health related quality of life (HRQoL) and symptoms. In this open-label randomised controlled trial, patients with symptomatic MPE were randomly assigned to either IPC insertion with the option of talc pleurodesis or chest drain and talc pleurodesis. The primary endpoint was global health status, measured with the EORTC QLQ-C30 questionnaire at 30 days post-intervention. 142 participants were enrolled from July 2015 to December 2019. Of participants randomly assigned to IPC (n=70) and chest drain (n=72), primary outcome data were available in 58 and 56 patients, respectively. Global health status improved in both groups at day 30 compared to baseline: IPC (mean difference 13.11 p While HRQoL significantly improved in both groups, there were no differences in patient reported global health status at 30 days. The outpatient pathway using an IPC was not superior to inpatient treatment with a chest drain. ISRCTN registration:15503522.

Sections du résumé

BACKGROUND BACKGROUND
The principal aim of malignant pleural effusion (MPE) management is to improve health related quality of life (HRQoL) and symptoms.
METHODS METHODS
In this open-label randomised controlled trial, patients with symptomatic MPE were randomly assigned to either IPC insertion with the option of talc pleurodesis or chest drain and talc pleurodesis. The primary endpoint was global health status, measured with the EORTC QLQ-C30 questionnaire at 30 days post-intervention. 142 participants were enrolled from July 2015 to December 2019.
RESULTS RESULTS
Of participants randomly assigned to IPC (n=70) and chest drain (n=72), primary outcome data were available in 58 and 56 patients, respectively. Global health status improved in both groups at day 30 compared to baseline: IPC (mean difference 13.11 p
CONCLUSION CONCLUSIONS
While HRQoL significantly improved in both groups, there were no differences in patient reported global health status at 30 days. The outpatient pathway using an IPC was not superior to inpatient treatment with a chest drain.
TRIAL REGISTRATION BACKGROUND
ISRCTN registration:15503522.

Identifiants

pubmed: 37996243
pii: 13993003.01215-2022
doi: 10.1183/13993003.01215-2022
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.

Auteurs

Parthipan Sivakumar (P)

Department of Thoracic Medicine, Guy's and St Thomas' NHS Trust, London, United Kingdom deepan.sivakumar@kcl.ac.uk.
King's College London, London, United Kingdom.

Deirdre B Fitzgerald (DB)

Pleural Medicine Unit, Institute for Respiratory Health, Western Australia, Australia.
Respiratory Department, Sir Charles Gairdner Hospital, Western Australia, Australia.

Hugh Ip (H)

Respiratory Department, Royal Free Hospital NHS Trust, London, United Kingdom.

Deepak Rao (D)

Department of Thoracic Medicine, Princess Royal University Hospital (King's College Hospital NHS Foundation Trust), Orpington, United Kingdom.

Alex West (A)

Department of Thoracic Medicine, Guy's and St Thomas' NHS Trust, London, United Kingdom.

Farinaz Noorzad (F)

St George's Hospital, London, United Kingdom.

Deirdre Wallace (D)

Guy's and St Thomas' NHS Trust, London, United Kingdom.

Mohamed Haris (M)

University Hospital of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom.

Benjamin Prudon (B)

Department of Respiratory Medicine, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, United Kingdom.

Gihan Hettiarachchi (G)

Medway NHS Foundation Trust, Gillingham, United Kingdom.

Deepak Jayaram (D)

Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom.

James Goldring (J)

Centre for Respiratory Medicine, Royal Free Hospital, London, United Kingdom.

Nick Maskell (N)

Academic Respiratory Unit, University of Bristol, Bristol, United Kingdom.

Jayne Holme (J)

North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.

Neel Sharma (N)

Respiratory Medicine, East Sussex NHS Trust, Eastbourne, United Kingdom.

Iyad Ismail (I)

University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom.

Owais Kadwani (O)

Guys and St Thomas NHS Foundation Trust, London, United Kingdom.

Sanchez Simpson (S)

Department of Thoracic Medicine, Guy's and St Thomas' NHS Trust, London, United Kingdom.

Catherine A Read (CA)

Pleural Medicine Unit, Institute for Respiratory Health, Western Australia, Australia.

Xiaohui Sun (X)

King's College London, School of Population Health and Environmental Sciences, London, United Kingdom.

Abdel Douiri (A)

King's College London, School of Population Health and Environmental Sciences, London, United Kingdom.

Yc Gary Lee (YG)

Respiratory Department, Sir Charles Gairdner Hospital, Western Australia, Australia.
Institute for Respiratory Health, University of Western Australia, Western Australia, Australia.

Liju Ahmed (L)

Department of Thoracic Medicine, King Faisal Specialist Hospital and Research Centre, Madinah, Kingdom of Saudi Arabia.

Classifications MeSH