Device assessed activity behaviours in patients with indwelling pleural catheter: A sub-study of the Australasian Malignant PLeural Effusion (AMPLE)-2 randomized trial.

Robert U Newton, Carolyn J Peddle-McIntyre, Sanjeevan Muruganandan, Joanne McVeigh, Deirdre B Fitzgerald, Leon Straker, Kevin Murray, Yun Chor Gary Lee

Journal: Respirology (Carlton, Vic.) 2023;28(6):561-570

PMID: 36642702

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Abstract

BACKGROUND AND OBJECTIVE

Device-assessed activity behaviours are a novel measure for comparing intervention outcomes in patients with malignant pleural effusion (MPE). Australasian Malignant PLeural Effusion (AMPLE)-2 was a multi-centre clinical trial where participants with MPE treated with an indwelling pleural catheter were randomized to daily (DD) or symptom-guided (SGD) drainage for 60-days. Our aim was to describe activity behaviour patterns in MPE patients, explore the impact of drainage regimen on activity behaviours and examine associations between activity behaviours and quality of life (QoL).

METHODS

Following randomization to DD or SGD, participants enrolled at the lead site (Perth) completed accelerometry assessment. This was repeated monthly for 5-months. Activity behaviour outcomes were calculated as percent of daily waking-wear time and compared between groups (Mann-Whitney U test; Median [IQR]). Correlations between activity behaviour outcomes and QoL were examined.

RESULTS

Forty-one (91%) participants provided ≥1 valid accelerometry assessment (DDn = 20, SGD n = 21). Participants spent a large proportion of waking hours sedentary (72%-74% across timepoints), and very little time in moderate-to-vigorous physical activity (<1% across timepoints). Compared to SGD group, DD group had a more favourable sedentary-to-light ratio in the week following randomization (2.4 [2.0-3.4] vs. 3.2 [2.4-6.1]; p = 0.047) and at 60-days (2.0 [1.9-2.9] vs. 2.9 [2.8-6.0]; p = 0.016). Sedentary-to-light ratio was correlated with multiple QoL domains at multiple timepoints.

CONCLUSION

Patients with MPE are largely sedentary. Preliminary results suggest that even modest differences in activity behaviours favouring the DD group could be meaningful for this clinical population. Accelerometry reflects QoL and is a useful outcome measure in MPE populations.

Address: Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, Australia.; School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.; Department of Respiratory Medicine, Northern Hospital, Melbourne, Victoria, Australia.; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.; School of Allied Health, Curtin University, Bentley, Western Australia, Australia.; Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa.; Respiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.; Institute for Respiratory Health & Medical School, University of Western Australia, Nedlands, Western Australia, Australia.; School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.; School of Population and Global Health, University of Western Australia, Nedlands, Western Australia, Australia.

DOI: 10.1111/resp.14451

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MeSH Terms: Humans, Pleural Effusion, Malignant, Quality of Life, Pleurodesis, Catheters, Indwelling, Drainage