TY - JOUR
T1 - Burden of Treatment Among Older Adults With Newly Diagnosed Multiple Myeloma
AU - Mian, Hira S.
AU - Fiala, Mark A.
AU - Wildes, Tanya M.
N1 - Funding Information:
H.M. reports honoraria/consultancy from Celgene, Takeda, Sanofi, Amgen, and Janssen. T.W. reports research funding from Janssen and consulting for Carevive Systems and Seattle Genetics. The other author has stated that he has no conflict of interest.
Funding Information:
We would like to acknowledge Carolyn Presley, The Ohio State University and Pamela Soulos, Yale University, who provided us with the SAS macro for treatment burden. Supported in part by the National Cancer Institute at the National Institutes of Health (NIH) (grant K12CA167540). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the National Center for Research Resources or the NIH. The Center for Administrative Data Research is supported in part by the Washington University Institute of Clinical and Translational Sciences (grant UL1 TR002345) from the National Center for Advancing Translational Sciences of the NIH and through the Agency for Healthcare Research and Quality (grant R24 HS19455). This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Program, National Cancer Institute; the Office of Research, Development and Information, Centers for Medicare and Medicaid Services; Information Management Services Inc; and the SEER program tumor registries in the creation of the SEER?Medicare Health Outcomes Survey database.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/2
Y1 - 2021/2
N2 - Background: Multiple myeloma is an incurable hematologic malignancy with significant recent treatment advances; however, the magnitude of treatment burden among patients in the first year after diagnosis has yet to be fully researched and reported. Patients and Methods: Patients with multiple myeloma newly diagnosed between 2007 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Treatment burden was captured as the number of total days with a health care encounter (including acute care and outpatient visits), oncology and nononcology physician visits, and the number of new prescriptions within the first year after diagnosis. Logistic regression was used to identify factors associated with high treatment burden. Results: A total of 3065 patients were included in the analysis. There was a substantial burden of treatment within the first year after diagnosis (median, 77 days; interquartile range, 55-105 days), which was highest during the first 3 months. Patients with high comorbidities (adjusted odds ratio [aOR] 1.27 per 1-point increase in Charlson comorbidity index, P < .001), poor performance status (aOR 1.85, P < .001), myeloma-related end organ damage, particularly bone disease (aOR 2.28, P < .001), and those who underwent autologous stem-cell transplantation (aOR 2.41, P < .001) were more likely to have a higher treatment burden. Conclusion: There is considerable burden of treatment in patients with newly diagnosed multiple myeloma within the first year after diagnosis, particularly within the first 3 months. Future tailored interventions aimed at optimizing this treatment burden when possible while simultaneously providing support to manage it may improve patient-centered care. We used the Surveillance, Epidemiology, and End Results–Medicare linked database to understand the treatment burden among 3065 newly diagnosed adults with multiple myeloma between 2007 and 2013, and factors associated with high treatment burden. There is a substantial burden of treatment, with over 2 months of cumulative interaction with health care in the first year. Future tailored interventions are required to optimize this burden whenever possible.
AB - Background: Multiple myeloma is an incurable hematologic malignancy with significant recent treatment advances; however, the magnitude of treatment burden among patients in the first year after diagnosis has yet to be fully researched and reported. Patients and Methods: Patients with multiple myeloma newly diagnosed between 2007 and 2013 were identified in the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked databases. Treatment burden was captured as the number of total days with a health care encounter (including acute care and outpatient visits), oncology and nononcology physician visits, and the number of new prescriptions within the first year after diagnosis. Logistic regression was used to identify factors associated with high treatment burden. Results: A total of 3065 patients were included in the analysis. There was a substantial burden of treatment within the first year after diagnosis (median, 77 days; interquartile range, 55-105 days), which was highest during the first 3 months. Patients with high comorbidities (adjusted odds ratio [aOR] 1.27 per 1-point increase in Charlson comorbidity index, P < .001), poor performance status (aOR 1.85, P < .001), myeloma-related end organ damage, particularly bone disease (aOR 2.28, P < .001), and those who underwent autologous stem-cell transplantation (aOR 2.41, P < .001) were more likely to have a higher treatment burden. Conclusion: There is considerable burden of treatment in patients with newly diagnosed multiple myeloma within the first year after diagnosis, particularly within the first 3 months. Future tailored interventions aimed at optimizing this treatment burden when possible while simultaneously providing support to manage it may improve patient-centered care. We used the Surveillance, Epidemiology, and End Results–Medicare linked database to understand the treatment burden among 3065 newly diagnosed adults with multiple myeloma between 2007 and 2013, and factors associated with high treatment burden. There is a substantial burden of treatment, with over 2 months of cumulative interaction with health care in the first year. Future tailored interventions are required to optimize this burden whenever possible.
KW - Aged
KW - Healthcare utilization
KW - Hematologic malignancy
KW - Quality of life
KW - Supportive care
UR - http://www.scopus.com/inward/record.url?scp=85093698964&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2020.09.010
DO - 10.1016/j.clml.2020.09.010
M3 - Article
C2 - 33097433
AN - SCOPUS:85093698964
SN - 2152-2650
VL - 21
SP - e152-e159
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 2
ER -