Patient Preferences in empYema treatment (PAPY-study): are we investigating relevant outcomes for patients?

Parapneumonic pleural infection is a common clinical issue and limited data are available regarding patients' treatment preferences and the extent to which these preferences influence treatment decision-making. This study aimed to identify outcome measures that are most relevant for patients who underwent treatment for parapneumonic pleural infection. Data were collected through a questionnaire on treatment experiences and preferences, complemented by a structured interview. Between 2021 and 2023, patients treated at a single tertiary referral center were identified. Eligible patients had undergone either chest tube drainage (with or without intrapleural enzymatic therapy, IET) or surgery (open thoracotomy or video-assisted thoracoscopic surgery, VATS). A total of twelve patients met the inclusion criteria. Four were treated with a chest tube (with or without IET), and eight underwent surgical intervention, including those who initially received drainage but subsequently required surgery. Despite the small sample size, several consistent themes emerged. Pain and immobilization were identified as key patient-reported outcome measures of hospitalization and treatment. Furthermore, minimizing the risk of complications and reducing the duration of antibiotic treatment were identified as key treatment priorities. Following treatment, full recovery, returning to work, and performing daily activities were crucial outcomes for patients. This study identifies the patient-reported outcome measures most important to patients and highlights the need to incorporate them into future clinical research on parapneumonic pleural infection.