Burden of Treatment Among Older Adults With Newly Diagnosed Multiple Myeloma

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. 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. (C) 2020 Elsevier Inc. All rights reserved.

Automated summary

The study utilized a database to explore the treatment burden among newly diagnosed multiple myeloma patients, finding a significant burden in the first year, particularly within the first three months. Factors such as high comorbidities, poor performance status, and bone disease were associated with higher treatment burden.