复发/难治性多发性骨髓瘤(RRMM)患者治疗满意度的患者报告因素。
Patient-Reported Factors in Treatment Satisfaction in Patients with Relapsed/Refractory Multiple Myeloma (RRMM).
机构信息
Icahn School of Medicine at Mount Sinai, New York New York, USA
Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, Massachusetts, USA.
出版信息
Oncologist. 2019 Nov;24(11):1479-1487. doi: 10.1634/theoncologist.2018-0724. Epub 2019 Aug 1.
BACKGROUND
Therapy choices in relapsed/refractory multiple myeloma (RRMM) should consider patient satisfaction with treatment, because it is associated with adherence to therapy, health outcomes, and medical safety. The primary objective of this pilot cross-sectional observational study was to ascertain factors associated with patient-reported treatment satisfaction in RRMM.
PATIENTS AND METHODS
Patients with a self-reported diagnosis of RRMM recruited from PatientsLikeMe, MyelomaCrowd, and Facebook were administered an electronic survey that included questions on demographics and clinical history, treatment experience, economic burden, and standardized patient-reported outcome measures, including the Treatment Satisfaction Questionnaire for Medication, Eastern Cooperative Oncology Group performance status (ECOG PS) measure, and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem V2.0. Univariable and multivariable analyses were used to identify predictors of patient-perceived treatment satisfaction.
RESULTS
One hundred sixty patients with RRMM participated in the study, with a median of two prior relapses and 66.3% reporting the most recent relapse within the last 12 months. ECOG PS ≥2 was associated with lower patient-reported global satisfaction and perceived effectiveness of current treatment. In addition to shorter time spent receiving therapy, orally administered treatment was the strongest predictor of higher satisfaction with treatment convenience. For patients receiving an injectable drug-containing regimen versus an all-oral regimen, respectively, time spent receiving multiple myeloma-directed therapy was higher (12.6 vs. 4.0 hours per month), and total monthly indirect costs were $1,033 and $241.
CONCLUSION
Poor ECOG PS was linked to reduced treatment satisfaction and perceived effectiveness of current therapy, whereas an all-oral regimen was associated with increased treatment convenience satisfaction.
IMPLICATIONS FOR PRACTICE
This study suggests that attributes including better Eastern Cooperative Oncology Group performance status, less time spent receiving treatment, and oral route of treatment administration lead to higher patient-perceived satisfaction with relapsed/refractory multiple myeloma (RRMM) treatment. Oral route of administration was also associated with less time spent receiving treatment and reduced economic burden for patients. Increased attention to these factors in shared treatment decision making is warranted to help identify individual patient needs, preferences, and expectations for RRMM treatments, to resolve dissatisfaction issues, and to improve the experience of patients with RRMM.
背景
在复发性/难治性多发性骨髓瘤(RRMM)中,治疗选择应考虑患者对治疗的满意度,因为它与治疗依从性、健康结果和医疗安全性相关。本初步横断面观察性研究的主要目的是确定与 RRMM 患者报告的治疗满意度相关的因素。
患者和方法
从 PatientsLikeMe、MyelomaCrowd 和 Facebook 招募了自报诊断为 RRMM 的患者,并对其进行了电子调查,其中包括人口统计学和临床病史、治疗经验、经济负担以及标准化的患者报告结果测量,包括治疗满意度问卷药物、东部合作肿瘤学组表现状态(ECOG PS)量表和工作生产力和活动障碍问卷:特定健康问题 V2.0。使用单变量和多变量分析来确定患者感知治疗满意度的预测因素。
结果
160 名 RRMM 患者参与了这项研究,中位数为两次复发,66.3%的患者报告最近一次复发发生在过去 12 个月内。ECOG PS≥2 与患者报告的整体满意度和当前治疗效果降低相关。除了接受治疗的时间缩短外,口服治疗是治疗便利性满意度更高的最强预测因素。对于接受含注射药物方案和全口服方案的患者,分别为每月接受多发性骨髓瘤靶向治疗的时间更高(12.6 小时与 4.0 小时),每月总间接费用分别为 1033 美元和 241 美元。
结论
较差的 ECOG PS 与治疗满意度降低和当前治疗效果降低相关,而全口服方案与治疗便利性满意度提高相关。
实践意义
本研究表明,包括更好的东部合作肿瘤学组表现状态、接受治疗的时间缩短和口服治疗途径在内的属性可提高患者对复发性/难治性多发性骨髓瘤(RRMM)治疗的满意度。口服途径还与接受治疗的时间缩短和患者经济负担减轻有关。在共同治疗决策中更加关注这些因素,以帮助确定个体患者对 RRMM 治疗的需求、偏好和期望,解决不满问题,并改善 RRMM 患者的体验。