Management of malignant pleural effusion in Italian clinical practice: a nationwide survey
Abstract Background Pleural disease (PD), particularly malignant pleural effusion (MPE), is a common cause of hospital admission and its prevalence is rising worldwide. Recent advances in diagnostic and therapeutic options, such as Indwelling Pleural Catheters (IPCs), have simplified PD treatment, a...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02530-4 |
| _version_ | 1797779065464160256 |
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| author | Federico Mei Mario Tamburrini Francesca Gonnelli Luca Morandi Martina Bonifazi Michele Sediari Alessandro di Marco Berardino Emanuela Barisione Giuseppe Failla Lina Zuccatosta Alberto Papi Stefano Gasparini Giampietro Marchetti |
| author_facet | Federico Mei Mario Tamburrini Francesca Gonnelli Luca Morandi Martina Bonifazi Michele Sediari Alessandro di Marco Berardino Emanuela Barisione Giuseppe Failla Lina Zuccatosta Alberto Papi Stefano Gasparini Giampietro Marchetti |
| author_sort | Federico Mei |
| collection | DOAJ |
| description | Abstract Background Pleural disease (PD), particularly malignant pleural effusion (MPE), is a common cause of hospital admission and its prevalence is rising worldwide. Recent advances in diagnostic and therapeutic options, such as Indwelling Pleural Catheters (IPCs), have simplified PD treatment, allowing an effective outpatients management. Therefore, dedicated pleural services can improve PD care, guaranteeing specialized management and optimizing time and cost. We aimed to provide an overview on MPE management in Italy, mainly focused on distribution and characteristics of pleural services and IPCs use. Methods A nationwide survey, endorsed by the Italian Thoracic Society, was distributed by email to members of selected subgroups in 2021. Results Ninety (23%) members replied, most of whom being pulmonologists (91%). MPE resulted the most common cause of pleural effusion and was managed with heterogenous approaches, including talc pleurodesis via slurry (43%), talc poudrage (31%), repeated thoracentesis (22%) and IPCs insertion (2%). The setting of IPC insertion was inpatient care in 48% of cases, with a predominance of draining frequency every other day. IPC management mainly relied on caregivers (42%). The presence of a pleural service was reported by 37% of respondents. Conclusions The present study provides an extensive overview of MPE management in Italy, showing a highly heterogeneous approach, a scarce prevalence of out-patient pleural services, and a still limited adoption of IPCs, mainly due to lack of dedicated community care systems. This survey emphasizes the need of promoting a higher spreading of pleural services and an innovative healthcare delivery with more favourable cost-benefit ratio. |
| first_indexed | 2024-03-12T23:26:20Z |
| format | Article |
| id | doaj.art-9030b2866a4744dab8286e3762d0cbf2 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-12T23:26:20Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-9030b2866a4744dab8286e3762d0cbf22023-07-16T11:08:23ZengBMCBMC Pulmonary Medicine1471-24662023-07-012311710.1186/s12890-023-02530-4Management of malignant pleural effusion in Italian clinical practice: a nationwide surveyFederico Mei0Mario Tamburrini1Francesca Gonnelli2Luca Morandi3Martina Bonifazi4Michele Sediari5Alessandro di Marco Berardino6Emanuela Barisione7Giuseppe Failla8Lina Zuccatosta9Alberto Papi10Stefano Gasparini11Giampietro Marchetti12Respiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarcheRespiratory Medicine, Emergency Department, Azienda Ospedaliero Universitaria FerraraRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarcheRespiratory Medicine, Emergency Department, Azienda Ospedaliero Universitaria FerraraRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarcheRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarcheRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarcheUOC Interventional Pulmonology, IRCCS Ospedale Policlinico San MartinoInterventional Pulmunology, Ospedale A. CardarelliRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarcheRespiratory Medicine, Emergency Department, Azienda Ospedaliero Universitaria FerraraRespiratory Diseases Unit, Department of Internal Medicine, Azienda Ospedaliero Universitaria delle MarchePulmonology Unit, ASST Spedali CiviliAbstract Background Pleural disease (PD), particularly malignant pleural effusion (MPE), is a common cause of hospital admission and its prevalence is rising worldwide. Recent advances in diagnostic and therapeutic options, such as Indwelling Pleural Catheters (IPCs), have simplified PD treatment, allowing an effective outpatients management. Therefore, dedicated pleural services can improve PD care, guaranteeing specialized management and optimizing time and cost. We aimed to provide an overview on MPE management in Italy, mainly focused on distribution and characteristics of pleural services and IPCs use. Methods A nationwide survey, endorsed by the Italian Thoracic Society, was distributed by email to members of selected subgroups in 2021. Results Ninety (23%) members replied, most of whom being pulmonologists (91%). MPE resulted the most common cause of pleural effusion and was managed with heterogenous approaches, including talc pleurodesis via slurry (43%), talc poudrage (31%), repeated thoracentesis (22%) and IPCs insertion (2%). The setting of IPC insertion was inpatient care in 48% of cases, with a predominance of draining frequency every other day. IPC management mainly relied on caregivers (42%). The presence of a pleural service was reported by 37% of respondents. Conclusions The present study provides an extensive overview of MPE management in Italy, showing a highly heterogeneous approach, a scarce prevalence of out-patient pleural services, and a still limited adoption of IPCs, mainly due to lack of dedicated community care systems. This survey emphasizes the need of promoting a higher spreading of pleural services and an innovative healthcare delivery with more favourable cost-benefit ratio.https://doi.org/10.1186/s12890-023-02530-4Pleural serviceIndwelling pleural catheterPleural diseasesMalignant pleural effusion, outpatient care |
| spellingShingle | Federico Mei Mario Tamburrini Francesca Gonnelli Luca Morandi Martina Bonifazi Michele Sediari Alessandro di Marco Berardino Emanuela Barisione Giuseppe Failla Lina Zuccatosta Alberto Papi Stefano Gasparini Giampietro Marchetti Management of malignant pleural effusion in Italian clinical practice: a nationwide survey BMC Pulmonary Medicine Pleural service Indwelling pleural catheter Pleural diseases Malignant pleural effusion, outpatient care |
| title | Management of malignant pleural effusion in Italian clinical practice: a nationwide survey |
| title_full | Management of malignant pleural effusion in Italian clinical practice: a nationwide survey |
| title_fullStr | Management of malignant pleural effusion in Italian clinical practice: a nationwide survey |
| title_full_unstemmed | Management of malignant pleural effusion in Italian clinical practice: a nationwide survey |
| title_short | Management of malignant pleural effusion in Italian clinical practice: a nationwide survey |
| title_sort | management of malignant pleural effusion in italian clinical practice a nationwide survey |
| topic | Pleural service Indwelling pleural catheter Pleural diseases Malignant pleural effusion, outpatient care |
| url | https://doi.org/10.1186/s12890-023-02530-4 |
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