Inspired Researcher: Sanjeevan Muruganandan

March 29, 2022

This week is Research Week, when we celebrate our many inspired researchers at Northern Health. In our story yesterday, Professor Peter Brooks AM, Research Lead here at Northern Health, highlighted the many research studies our staff are involved in. Dr Sanjeevan Muruganandan features prominently in this list.

Dr Sanjeevan Muruganandan, Northern Health lung specialist and pleural lead, would like to change the way we manage malignant pleural effusion (MPE).

Pleural diseases, which occur when there is a problem in the chest cavity, are common and the burden is increasing.

In Victoria, the current standard of care for MPE involves pleurodesis, which Sanjeevan maintains is costly, painful and associated with prolonged hospital admissions.

Says Sanjeevan, “One in four people with MPE will need a repeat procedure post-pleurodesis during their short lifespan. Yet, health services generally do not always offer alternatives to pleurodesis despite current guideline.”

He blames this on “clinical inertia” and says, “One of the possible major barriers is a lack of expertise across other health services.”

He, along with Kirstin Tirant, Pleural Clinical Nurse Consultant, are showing there is a better way, through their Specialised Ambulatory Pleural Service (SAPS), a subsidiary of the Pleural Medicine Unit here at Northern Health. SAPS aims to improve access to evidence-based and minimally invasive management options for pleural diseases that will eventually result in reduced healthcare utilisation.

Sanjeevan, supported by the Northern Health Respiratory Department, was successful in his application for a grant from the HCF Research Foundation, that will help evaluate the feasibility of expanding this, Victoria’s first Specialised Ambulatory Pleural Service.

“Digitalising the SAPS model-of care will revolutionise a program that already applies evidence-based management strategies, that will not only reduce hospitalisation but further enhance the utilisation of an ambulatory model of care,” says Sanjeevan.

Celebrating 20 years of contributions to healthcare research, the HCF Research Foundation was established to drive research, enquiry and innovation in the delivery of healthcare.

The HCF Research Foundation received 125 high quality applications across Australia, making it a very competitive process.

Titled, ‘Digital Health to Extend Victoria’s First Specialised Ambulatory Pleural Service: A Proof-of-Concept Feasibility Study,’ Sanjeevan’s application represents a paradigm shift within the Victorian health system, towards a specialised, but ultimately person-centred, approach to MPE management.

As his application says, “The management of malignant pleural effusion (MPE) remains fragmented in Australia with very different care models, employed across health services that may result in suboptimal quality care leading to poor outcomes in this vulnerable population group. Despite high quality evidence that indwelling pleural catheters (IPC) reduces time spent in hospital and the need for further invasive pleural intervention, utilisation of IPC has been poor.”

He explains that most health services are not equipped with the expertise or resources to support IPC in the community.

“Difficulty accessing hospital services due to the COVID-19 pandemic will inevitably worsen outcomes for MPE in coming years and novel approaches are needed.”

Sanjeevan firmly believes that to maximise independence and quality of life benefits, IPC management in the community requires, “an innovative, flexible and responsive model-of-care to deliver expertise to patients when they need it, while avoiding frequent hospital and clinic visits.”

The funding support from the HCF Foundation will ensure this novel model-of-care is appropriately evaluated. The study will determine feasibility and safety, while comparing outcomes and patient satisfaction.

Sanjeevan hopes that the results will drive further expansion of a digital health approach to managing MPE in the community.

The Northern Health Research Week Abstract Book 2022 is now available, with details on Research Week presentations and showcasing the research being done by our Northern Health researchers and collaborators.

For more information, please visit the Research Week pages here.

View the virtual Research Week 2022 posters here and cast your vote on the best poster for the People’s Choice Award for Best Poster.