Twenty‐five years of <i>Respirology</i>: Advances in pleural disease

Lui, Macy Mei Sze; Lee, Gary

doi:10.1111/resp.13742

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…All too often implementation was unsuccessful or not sustained due to various barriers in the implementation process [ 14 ]. Pleural medicine, an example of a rapidly evolving field in internal medicine, deserves special attention as it is a prevalent medical problem, with paradigm-changing evidence and advances emerged in the recent decade in both diagnostic and therapeutic aspects within the field [ 6 ]. Our study has highlighted that insufficient structured training, knowledge transfer from the specialists to non-specialists, lack of timely resource allocation to service enhancement are the possible factors prohibiting the uptake of advances into the local practice of pleural medicine in Hong Kong.…”

Section: Discussionmentioning

confidence: 99%

“…Indwelling pleural catheter has evolved to become the first line management approach to definitive control for MPE in many developed regions of the world [ 32 ]. IPC has offered an ambulatory option for MPE drainage at home, allowing early discharge from hospital and empowering self-care [ 6 ]. Our survey reveals that IPC was available in all the participating hospitals, and yet it was not the most prevailing management approach for MPE among survey participants.…”

Section: Discussionmentioning

confidence: 99%

“…In the past decade, the field of pleural medicine has witnessed significant advances [ 5 ], with landmark publications of practice-changing multi-centred randomized controlled trials and release of clinical guidelines. In particular, there are major breakthroughs in the understanding, investigation and treatments of common pleural diseases [ 6 ], which can reduce morbidity and improve quality of care for patients. However, the incorporation of major advances into clinical practice can vary tremendously across different healthcare systems [ 7 , 8 ], and there are a number of possible barriers contributing to the insufficient update and lack of implementation of guidelines and advances [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implementation of evidence on management of pleural diseases: insights from a territory-wide survey of clinicians in Hong Kong

Lui

Yeung²,

Ngai

et al. 2022

BMC Pulm Med

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Background Major advances in management of common pleural diseases have taken place in the past decade. However, pleural diseases are often managed by physicians of diverse training background and research on implementation of new knowledge is scanty. We aim to evaluate the practice pattern in pleural medicine among physicians in Hong Kong, for identification of possible gaps for clinical service improvement. Methods The Hong Kong Thoracic Society undertook a cross-sectional questionnaire survey in 2019, targeting clinicians of various subspecialties in internal medicine and levels of experience (basic and higher trainees, specialists) from twelve regional hospitals of diverse service scopes throughout Hong Kong. Respondents were selected by non-probability quota sampling. The questionnaire tool consisted of 46 questions covering diagnostic and therapeutic aspects of common pleural diseases. The responses were anonymous, and analysed independently using SPSS statistics software. Results The survey collected 129 responses, 47(36%) were from clinicians specialized in respiratory medicine. Majority of the respondents (98%) managed pleural diseases, including performing pleural procedures in their practice. Fifty-five percent of all the respondents had not received any formal training in transthoracic ultrasonography. A significant proportion of clinicians were unaware of pleuroscopy for investigation of exudative pleural effusion, indwelling pleural catheter for recurrent malignant pleural effusion, and combined intra-pleural Alteplase plus DNase for treatment of pleural infection (30%, 15% and 70% of non-respiratory clinicians respectively). Significant heterogeneity was found in the management of pleural infection, malignant pleural effusion and pneumothorax among respiratory versus non-respiratory clinicians. Contributing factors to the observed heterogeneity included lack of awareness or training, limited accessibility of drugs, devices, or dedicated service support. Conclusion Significant heterogeneity in management of pleural diseases was observed among medical clinicians in Hong Kong. Continuous medical education and training provision for both specialists and non-specialists has to be strengthened to enhance the implementation of advances, improve quality and equity of healthcare provision in pleural medicine.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Implementation of evidence on management of pleural diseases: insights from a territory-wide survey of clinicians in Hong Kong

Lui

Yeung²,

Ngai

et al. 2022

BMC Pulm Med

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An Inexpensive Way to Drain Malignant Effusions With Indwelling Pleural Catheters and Its Impact on Performance Status and Pleurodesis. Experience from a Tertiary Hospital in México

Rendón-Ramírez

Cedillo-Huerta

Colunga‐Pedraza

et al. 2020

Open Respiratory Archives

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Pleural effusions and pneumothorax: Beyond simple plumbing

et al. 2020

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Pleural diseases affect millions of people worldwide. Pleural infection, malignant pleural diseases and pneumothorax are common clinical challenges. A large number of recent clinical trials have provided an evidence‐based platform to evaluate conventional and novel methods to drain pleural effusions/air which reduce morbidity and unnecessary interventions. These successes have generated significant enthusiasm and raised the profile of pleural medicine as a new subspecialty. The ultimate goal of pleural research is to prevent/stop development of pleural effusions/pneumothorax. Current research studies mainly focus on the technical aspects of pleural drainage. Significant knowledge gaps exist in many aspects such as understanding of the pathobiology of the underlying pleural diseases, pharmacokinetics of pleural drug delivery, etc. Answers to these important questions are needed to move the field forward. This article collates opinions of leading experts in the field in highlighting major knowledge gaps in common pleural diseases to provoke thinking beyond pleural drainage. Recognizing the key barriers will help prioritize future research in the quest to ultimately cure (rather than just drain) these pleural conditions.

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Twenty‐five years of Respirology: Advances in pleural disease

Cited by 3 publications

References 21 publications

Implementation of evidence on management of pleural diseases: insights from a territory-wide survey of clinicians in Hong Kong

Implementation of evidence on management of pleural diseases: insights from a territory-wide survey of clinicians in Hong Kong

An Inexpensive Way to Drain Malignant Effusions With Indwelling Pleural Catheters and Its Impact on Performance Status and Pleurodesis. Experience from a Tertiary Hospital in México

Pleural effusions and pneumothorax: Beyond simple plumbing

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