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Ayto R, Annibali O, Biedermann P, Roset M, Sánchez E, Kotb R. The EASEMENT study: A multicentre, observational, cross-sectional study to evaluate patient preferences, treatment satisfaction, quality of life, and healthcare resource use in patients with multiple myeloma receiving injectable-containing or fully oral therapies. Eur J Haematol 2024; 112:889-899. [PMID: 38389468 DOI: 10.1111/ejh.14180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE As multiple myeloma (MM) therapies advance, understanding patients', caregivers', and physicians' perspectives on, and satisfaction with, available treatment options and their impact on quality of life (QoL), is important. METHODS EASEMENT is a real-world, observational, cross-sectional study conducted in 19 sites within the UK, Canada, and Italy using retrospective chart reviews and surveys. Enrolled patients had clinical history available since diagnosis and had received ≥1 cycle of their current line of therapy. Primary objectives were to describe patient/caregiver QoL (EQ-5D-5L questionnaire), patient preference for oral/injectable therapies (single discrete-choice question), and patient satisfaction (TSQM-9 questionnaire). RESULTS Between October 2018 and March 2020, 399 patients were enrolled (n = 192 newly diagnosed multiple myeloma [NDMM], n = 206 relapsed/refractory multiple myeloma [RRMM], n = 1 missing). Among NDMM and RRMM patients, 78%/22% and 42%/58% were receiving injectables/orals, respectively. Both NDMM and RRMM patients significantly preferred orals versus injectables (p < .0001). No significant differences were reported in treatment satisfaction or QoL, but treatment convenience favoured orals over injectables with near significance (p = .053). CONCLUSION MM patients perceived greater convenience and preference for orals versus injectables. Oral treatments are useful for patients who cannot or prefer not to travel to clinics, or cannot perform self-injection within the community.
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Affiliation(s)
- Robert Ayto
- Department of Haematology, Queen Alexandra Hospital, Portsmouth, UK
| | - Ombretta Annibali
- Hematology, Stem Cell Transplantation, Fondazione Policlinico Universitario Campus Bio Medico di Roma, Rome, Italy
| | - Patricia Biedermann
- Medical Affairs, Europe & Canada, Takeda Pharmaceuticals International AG, Zurich, Switzerland
| | | | | | - Rami Kotb
- Medical Oncology & Hematology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Guio J, Melo A, Saldarriaga MM, Fuentes C, Tíjaro-Ovalle N, Borda A, Guzmán Y, Bolaños E, Quintero G, Duarte M, Agudelo C, Aparicio S, Cuellar G, Bernal P, Paéz M, Rueda E, Rodriguez A, Alvarado F, Pinzón O, Romero M. A Novel Digital Educational Strategy Improves Treatment Adherence and Quality of Life in Patients with Multiple Myeloma. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:50-57. [PMID: 37875743 DOI: 10.1007/s13187-023-02374-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/26/2023]
Abstract
Multiple myeloma, the second most common hematologic malignancy worldwide, is an aggressive disease with high morbidity and mortality rates. Although myeloma remains incurable, new treatments have improved patients' life expectancy and quality of life. However, as these therapies are administered for prolonged and often indefinite periods, their success depends on high treatment adherence and significant patient engagement. This study aimed to evaluate the impact of a novel digital educational strategy on treatment adherence, quality of life, and the development of complications in patients with newly diagnosed myeloma. To this end, a two-arm, randomized, prospective, double-blind study was conducted to compare the conventional educational approach alone or combined with the novel digital strategy. This strategy was based on some principles of the Persuasive Systems Design model and incorporated the educational recommendations of patients and caregivers. Compared to the control group that only received information through the conventional educational approach, patients randomized to the digital strategy showed significantly higher treatment adherence and quality of life, associated with increased functionality and rapid reincorporation into daily routines. The digital strategy empowered patients and caregivers to understand the disease and therapeutic options and helped patients recall treatment information and implement healthy lifestyle habits. These results support that patient-targeted educational strategies can positively influence treatment adherence and thus improve their quality of life.
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Affiliation(s)
- Juan Guio
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Andrés Melo
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Hematology and Hemotherapy Division, Hospital Clinico San Carlos, Madrid, Spain
| | - Mateo Mejía Saldarriaga
- Hematology and Oncology Division, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Cynthia Fuentes
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Andrés Borda
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Yuli Guzmán
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Elías Bolaños
- Education and Knowledge Management, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Guillermo Quintero
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Mónica Duarte
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Claudia Agudelo
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Soraya Aparicio
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Psychiatry, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Gina Cuellar
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Patricia Bernal
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Nuclear Medicine, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Marco Paéz
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Erica Rueda
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Cancer Institute, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Agustina Rodriguez
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Fernando Alvarado
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Oscar Pinzón
- Enterprise Analytics Division, Memorial Hermann Health System, Houston, TX, USA
| | - Martha Romero
- Center of Excellence for Multiple Myeloma, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.
- Department of Pathology and Laboratory, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.
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Charliński G, Grząśko N, Bołkun Ł, Sawicki W, Paczkowska E, Druzd-Sitek A, Usnarska-Zubkiewicz L, Butrym A, Wiater E, Boguradzki P, Budziszewska B, Wojciechowska M, Mordak-Domagała M, Jurczyszyn A. Therapeutic adherence and assessment of satisfaction patients with multiple myeloma treated with immunomodulatory drugs in a "real-world" study: Experiences of the Polish Myeloma Group. J Oncol Pharm Pract 2023:10781552231203371. [PMID: 37728209 DOI: 10.1177/10781552231203371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
INTRODUCTION Therapeutic adherence (TA) is one of the most important factors influencing the effectiveness of treatment. Oral anti-cancer drugs are increasingly used to treat malignancy including multiple myeloma (MM). Our study aimed to determine TA of patients with MM treated with IMiDs, to identify TA risk factors, and to determine satisfaction with medical care during the treatment with IMiDs. METHODS A cross-sectional survey-based study involving adult patients with MM treated with IMiDs. RESULTS Between January 2021 and May 2021, 267 patients with MM were enrolled in the study. The dosing schedule was declared as easy by 71.8% of patients, as standard for 24.0%, and difficult for 4.2% of patients. During MM treatment, 85.0% of patients did not skip any IMiDs dose, and 87.6% did not skip the IMiDs dose in the last cycle of chemotherapy. Identified factors affecting TA included the treatment duration and education level. In addition, depending on the patient's well-being, gender, and household companionship influenced TA. Satisfaction with medical care during the treatment with IMiDs was declared by 95.5% of patients with MM. In our cohort, 95.5% of patients were satisfied with the information they received from the hematologist during treatment with IMiDs. CONCLUSIONS Patients with MM treated with IMiDs are highly adherent to treatment. With time from the beginning of treatment, patients need more attention and motivation to adhere to the therapy rules.
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Affiliation(s)
- Grzegorz Charliński
- Department of Internal Medicine, Medical Faculty, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
- Department of Hematology, Nicolaus Copernicus Hospital, Torun, Poland
| | - Norbert Grząśko
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Łukasz Bołkun
- Department of Hematology, Medical University in Białystok, Białystok, Poland
| | - Waldemar Sawicki
- Department of Internal Medicine and Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Edyta Paczkowska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Agnieszka Druzd-Sitek
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Lidia Usnarska-Zubkiewicz
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Medical University, Wroclaw, Poland
| | - Aleksandra Butrym
- Department of Cancer Prevention and Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Elżbieta Wiater
- Department of Hematology, Nicolaus Copernicus Hospital, Torun, Poland
| | - Piotr Boguradzki
- Department of Haematology, Transplantology, and Internal Diseases, University Clinical Centre, Medical University of Warsaw, Warsaw, Poland
| | - Bożena Budziszewska
- Hematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Monika Mordak-Domagała
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland
| | - Artur Jurczyszyn
- Department of Haematology, Faculty of Medicine, Plasma Cell Dyscrasias Center, Jagiellonian University, Kraków, Poland
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Ailawadhi S, Ogbonnaya A, Murty S, Cherepanov D, Schroader BK, Romanus D, Farrelly E, Chari A. Duration of frontline therapy and impact on clinical outcomes in newly diagnosed multiple myeloma patients not receiving frontline stem cell transplant. Cancer Med 2023; 12:3145-3159. [PMID: 36151787 PMCID: PMC9939178 DOI: 10.1002/cam4.5239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 08/06/2022] [Accepted: 09/02/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Extended first-line therapy (1LT) has improved clinical outcomes in newly diagnosed multiple myeloma (NDMM). This retrospective study of NDMM patients evaluated the relationship between dose-attenuation of 1LT and duration of therapy (DOT) and DOT on outcomes. METHODS Adults with NDMM not undergoing stem cell transplant (SCT) from January 1, 2012 toMarch 31, 2018 from the Integrated Oncology Network were included; 300 were randomly selected for chart review. 1LT DOT, time to next treatment (TTNT), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier analysis. Marginal structural models evaluated relationships between DOT and TTNT, PFS, and OS at 2 years accounting for confounders and survival bias from the time-dependent nature of DOT. RESULTS Of 300 chart-reviewed patients, 93 were excluded for incomplete data or meeting exclusion criteria. Among 207 NDMM patients, median age was 74 years; 146 (70.5%) did not receive dose-attenuation during 1LT. Patients with short DOT were older, frailer, with a higher comorbidity burden, and a significantly lower proportion had an Eastern Cooperative Oncology Group PS = 0. As DOT increased, more patients underwent dose-attenuation (p < 0.0001). The median 1LT DOT was 20.9 (95% confidence interval [CI]: 13.9, 26.4) versus 4.2 months (95% CI: 3.2, 4.9) for patients receiving versus not receiving dose-attenuation, respectively (p < 0.0001). After accounting for survival bias, confounder-adjusted TTNT was prolonged with each additional month of 1LT (odds ratio [OR]: 0.76 [95% CI: 0.75, 0.78]); likelihoods of risks of disease progression (OR: 0.87 [95% CI: 0.86, 0.88]) and death at 2 years (OR: 0.72 [95% CI: 0.70, 0.74]) were reduced with each month of 1LT (p < 0.0001 for all outcomes). CONCLUSIONS Dose-attenuated 1LT was associated with longer DOT among patients with non-SCT NDMM. Each additional month of 1LT was associated with a reduced adjusted likelihood of disease progression and death at 2 years. Dose-attenuation of 1LT can extend DOT; longer DOT may improve clinical outcomes.
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Affiliation(s)
- Sikander Ailawadhi
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, United States
| | | | | | - Dasha Cherepanov
- Takeda Development Center Americas, Inc (TDCA), Lexington, Massachusetts, United States
| | | | - Dorothy Romanus
- Takeda Development Center Americas, Inc (TDCA), Lexington, Massachusetts, United States
| | | | - Ajai Chari
- Hematology and Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
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Rosko AE, Cordoba R, Abel G, Artz A, Loh KP, Klepin HD. Advances in Management for Older Adults With Hematologic Malignancies. J Clin Oncol 2021; 39:2102-2114. [PMID: 34043442 PMCID: PMC8260925 DOI: 10.1200/jco.21.00242] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/23/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
- Ashley E. Rosko
- Division of Hematology, The Ohio State University, Columbus, OH
| | - Raul Cordoba
- Lymphoma Unit, Department of Hematology, Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Gregory Abel
- Leukemia Program, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Andrew Artz
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Kah Poh Loh
- James P. Wilmot Cancer Center, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY
| | - Heidi D. Klepin
- Section on Hematology and Oncology, Wake Forest Baptist Health, Winston-Salem, NC
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