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

Thorax. 2023 Nov;78(11):1111-1117. doi: 10.1136/thorax-2022-219449. Epub 2023 May 12.

Abstract

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.

Keywords: pleural disease.

MeSH terms

  • Catheters, Indwelling
  • Drainage
  • Dyspnea / therapy
  • Humans
  • Pleura
  • Pleural Effusion, Malignant* / therapy
  • Quality of Life