14414St. Luke's Health System, Division of Pulmonary and Critical Care, University of Missouri at Kansas City School of Medicine, Kansas City, MO, USA.
Division of Allergy, Pulmonary and Critical Care Medicine, 12328Vanderbilt University Medical Center, Nashville, TN, USA.
Am J Hosp Palliat Care. 2021 Apr;38(4):361-365. doi: 10.1177/1049909120954810. Epub 2020 Sep 1.
Indwelling pleural catheters (IPC) are effective at palliating benign and malignant pleural effusions (MPE). They have also been found to be cost effective from a third-party payor perspective. Little is known of the impact IPCs have on patient-centered quality of life outcomes such as financial burden and patient and caregiver burden. We performed a cross-sectional survey study evaluating the impact of IPCs on multiple patient and caregiver quality of life metrics.
Patients ≥ 18 years old with an IPC in place for 2 months were eligible. Twenty patients were recruited over a 10-month period. Patients completed the CDC-Health Related Quality of Life (HRQOL)-4 and a HRQOL-financial questionnaire. The primary objective was to describe the socio-economic impact of IPCs. Demographic and IPC specific data were collected. Descriptive statistics were used.
The mean (SD) age was 64.3 (0.70). The indication was MPE in 19/20. All patients had medical insurance. Medicare or Medicaid (CMS) comprised 10/20 of payors. The median (IQR) copay for private insurers was $238.45 (72-875); 11/20 had additional costs related to the IPC; 4/20 had significant life changes after the IPC; 17/20 received assistance from a non-paid caregiver; 6/20 patients could not do activities because of the IPC and this negatively impacted QOL in 3/6 of those patients.
Patients with IPCs may experience negative life consequences, incur additional medical expenses, and require assistance from a non-paid caregiver. Activities may be negatively impacted by IPC. Discussion of alternative means of symptom palliation and pleurodesis would be beneficial.
留置性胸腔导管（IPC）在缓解良性和恶性胸腔积液（MPE）方面具有疗效。从第三方支付者的角度来看，它们也具有成本效益。关于 IPC 对患者为中心的生活质量结果（如经济负担以及患者和护理人员负担）的影响，知之甚少。我们进行了一项横断面调查研究，评估了 IPC 对多种患者和护理人员生活质量指标的影响。
年龄≥18 岁且 IPC 放置时间≥2 个月的患者符合入选条件。在 10 个月的时间里共招募了 20 名患者。患者完成了疾病预防控制中心健康相关生活质量（HRQOL）-4 问卷和 HRQOL-财务问卷。主要目的是描述 IPC 的社会经济影响。收集了人口统计学和 IPC 特定数据。使用描述性统计数据。
平均（SD）年龄为 64.3（0.70）。20 例患者中，19 例的指征为 MPE。所有患者均有医疗保险。医疗保险或医疗补助（CMS）占支付者的 10/20。私人保险公司的平均（IQR）共付额为 238.45 美元（72-875）；11/20 例患者有与 IPC 相关的额外费用；4/20 例患者在 IPC 后生活发生重大变化；17/20 例患者得到非付费护理人员的帮助；6/20 例患者因 IPC 无法进行活动，这对其中 3/6 例患者的 QOL 产生了负面影响。
IPC 患者可能会经历负面的生活后果，产生额外的医疗费用，并需要非付费护理人员的帮助。IPC 可能会对活动产生负面影响。讨论替代的症状缓解和胸膜固定术方法将是有益的。
