Therapeutic thoracentesis symptoms and activity: a qualitative study

Area of Science:

• Oncology
• Pulmonology
• Palliative Care

Background:

• Malignant pleural effusions (MPEs) are common in advanced cancer, significantly impacting patient quality of life.
• Fluid drainage aims to alleviate symptoms and improve daily functioning in MPE patients.

Purpose of the Study:

• To investigate the impact of therapeutic aspiration on symptom experience and daily activities in patients with MPE.
• To enhance understanding of patient-reported outcomes following MPE drainage.

Main Methods:

• A qualitative study involving semistructured interviews with 16 patients undergoing diagnostic/therapeutic procedures for MPE.
• Framework analysis was independently conducted by two researchers to interpret interview data.

Main Results:

• Pre-drainage symptoms included breathlessness, cough, chest pain, fatigue, and anorexia, affecting mobility and socialisation.
• Post-drainage, respiratory symptoms and sleep quality improved for some, but fatigue and anorexia persisted.
• Patients reported increased activity post-aspiration, with benefits lasting only a few days, yet they deemed the procedure valuable.

Conclusions:

• Therapeutic aspiration offers temporary relief for respiratory symptoms and improves overall health in MPE patients.
• Constitutional symptoms, potentially linked to the underlying malignancy, do not improve with fluid drainage.
• Clinical trial outcomes for MPE should encompass a broader range of symptoms beyond dyspnea to accurately reflect patient benefits and inform patient expectations.