About Pleural Medicine Research
In Australia, pleural disease affects 60,000 patients per annum. Pleural malignancies and infections are the commonest causes of exudative pleural effusions, and their incidence, mortality and health-care costs continue to rise. The Pleural Medicine Unit is regarded as one of the most active pleural research groups in the world, and uniquely combines a clinical and a laboratory arm closely integrated with the most active tertiary pleural services in Australasia. The clinical service of the Unit is based at the Respiratory Dept of the Sir Charles Gairdner Hospital. The clinical and laboratory research is based at the University of Western Australia and the Institute for Respiratory Health.
The program focuses on translational research in common pleural diseases, especially cancer and infection, with a strong publication record on clinical trials from Phase I to multicentre randomised trials (RCTs). This is complemented by laboratory research in molecular biology. The focus is to undertake translational research and develop management strategies to improve patient care. Patient mortality and morbidity in malignant pleural effusion have improved as a direct result of this research with the subsequent improvement in clinical practice.
The now established use of indwelling pleural catheter (IPC) services in Western Australia and the treatment of pleural infection using novel intrapleural therapies has also positively impacted on patient care and the patient experience.
Advancing Research Efforts
Our meaningful and impactful research initiatives are making a real difference. Our research is being disseminated through prestigious publications at 19 conferences in 14 cities in 9 countries in the end of 2023 and have won 4 research awards, testifying the high standards of research that we are undertaking. One of our research studies, PLEASE-3, was launched last year, aimed to determine whether bending forward can predict if a patient will have breathelessness reflief after the pleural fluid is drained. There is potential to contribute valuable insights to our understanding of pleural fluids and breathelessness and will inform future patient care and prevent unnecessary, invasive pleural drainage procedures.
In 2023, we were awarded the Dust Diseases Board grant to purchase actigraphy devices, a cutting-edge tool that is instrumental in advancing our research goals. It empowers our team to conduct experiments with greater precision, collect more robust data and explore avenues of inquiry that were previously beyond our reach. We use these devices to test if receiving a program of dietetics, exercise physiology and psychology over 12-weeks can improve activity levels and quality of life for people with pleural cancer.
In addition, the results from the TAP-IPC study was published in the Respirology journal showcasing the depth and significance of our findings. This pilot study applied antibiotic cream (mupirocin) at the indwelling pleural catheter site to prevent bacteria from causing infections. What was initially a pilot study has now paved the way for a groundbreaking randomized control trial, AMPLE-4, and we have been succesful in obtaining a grant by the Cancer Council WA to fund this. Results from this randomised control trial will improve future patient care and could prevent complication that can occur in 10-20% of patients.
Impact in Action
The Pleura team has been the pioneer in organizing annual hands-on pleural procedure workshop that provides invaluable training to doctors and nurses on ultrasound techniques on animal and simulation models as well as on patients. The 2-day workshop is accreditated by the Australasian Society of Ultrasound Medicine. Stay tuned to find out when the next pleural project workshop will be in 2024.