Treatment Satisfaction and Burden of Illness in Patients with Newly Diagnosed Multiple Myeloma

Abstract

Objectives This observational study identified attributes of patient-reported satisfaction with therapy for multiple myeloma (MM), described the treatment-related time burden and indirect costs, and investigated the effect of administration route (oral vs. injectable) on these outcomes among patients with newly diagnosed MM (NDMM) and among caregivers. Methods Patients residing in the USA with a self-reported diagnosis of NDMM were recruited from PatientsLikeMe, MyelomaCrowd, and Facebook (16 December 2016 and 6 July 2017) to complete an electronic survey including questions on treatment experience, economic burden, and standardized patient-reported outcome measures, including the Treatment Satisfaction Questionnaire for Medication with three domains (global satisfaction, effectiveness, and convenience) and the Work Productivity and Activity Impairment Questionnaire. Univariate and multivariate analyses identified predictors of patient-perceived treatment satisfaction. Results Among 188 patients, worse Eastern Cooperative Oncology Group performance status (ECOG PS) was correlated with lower patient-perceived effectiveness and convenience of their current treatment. White race and oral administration route were independently correlated with higher patient-perceived convenience of treatment. Injectable therapy use was associated with a trend towards increased activity impairment (43 vs. 34%; p = 0.05) and significantly higher time burden of treatment administration, with threefold higher adjusted indirect costs of MM therapy compared with solely orally administered therapies (monthly mean $US482 vs. 153; 2016 values; p < 0.0001). Conclusions Factors associated with patient-perceived satisfaction with NDMM treatment-ECOG PS, race, administration route-warrant increased attention in shared treatment decision making to help identify patient needs and improve the patient's treatment experience. The use of orally administered therapies could improve patients' activity impairment and reduce the time burden associated with therapy. Pronabesh DasMahapatra is affiliated with PatientsLikeMe at time of study.

Patient Perceptions Regarding Multiple Myeloma and Its Treatment: Qualitative Evidence from Interviews with Patients in the United Kingdom, France, and Germany

“…To date, little attention has been given to the disease experiences or treatment preferences of patients with MM or how those preferences are shaped [ 3 ]. There is a paucity of research on treatment preferences of patients with newly diagnosed MM (NDMM) [ 3 , 14 ].…”

Health-Related Quality of Life in Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma: Findings From the Phase III MAIA Trial

“…ECOG PS has been shown to be independently associated with HRQoL in patients with MM, with higher ECOG PS (eg, ≥ 2) correlating with lower patient-perceived effectiveness of treatment. 29 - 31 In this analysis, HRQoL was improved or maintained with treatment regardless of ECOG PS, with greater improvements in GHS and pain in the D-Rd versus Rd group. These improvements, which were clinically meaningful and sustained through cycle 12, were achieved in a cohort of patients in which most (approximately 70%) had an ECOG PS of 1 or 2 at baseline.…”

Treatment Patterns and Outcomes Among Nontransplant Newly Diagnosed Multiple Myeloma Patients in Spain

“…However, the latest evidence supports the use of IMiD or PI-based maintenance therapy to improve PFS and OS in patients who achieve complete response or very good partial response to induction therapy. Orally administered maintenance therapy options are particularly suited for prolonged use due to convenience of administration [29]. Barriers to the implementation of maintenance therapy such as a lack of approval, toxicity, including secondary primary malignancies, cost and impact on the quality of life need to be further investigated [30].…”