Mount Sinai Hospital, New York, NY.
Translational Genomics Research Institute (TGen), City of Hope Cancer Center, Phoenix, AZ.
JCO Clin Cancer Inform. 2021 Oct;5:1096-1105. doi: 10.1200/CCI.20.00145.
Multiple myeloma (MM) is associated with the highest symptom burden and lowest health-related quality of life (HRQoL) among patients with hematologic malignancies. HRQoL in MM is heterogeneous, varying over the course of disease, with the highest burden at diagnosis and relapse. Patients with MM are increasingly being treated with oral maintenance medications at home. As a result, longitudinal monitoring of medication adherence and patient-reported outcomes, including HRQoL, could inform on disease status, therapeutic tolerability, and satisfaction with care. Digital health technologies, including telemedicine, mobile health, and wearable devices, are poised to become an integral part of modern health care, in part due to the surge in telemedicine necessitated by the COVID-19 pandemic. Although the literature has many reports on the use of digital health technologies in other types of cancers, fewer studies report on their application to MM. In the current narrative review, we survey the applications of digital health for MM. Although there is evidence that some are associated with improved health outcomes, challenges exist that must be met to ensure more widespread adoption. These include the need for increased awareness by patients and health care providers, lack of access by the typical older patient with MM, absence of randomized clinical trials, and low integration with current workflows such as electronic health records. Following our summary of technologies that could benefit patients with MM, we end by describing our vision for how they can be integrated into each phase of the patient journey.
多发性骨髓瘤（MM）是血液系统恶性肿瘤中症状负担最高、健康相关生活质量（HRQoL）最低的疾病。MM 患者的 HRQoL 存在异质性，在疾病过程中不断变化，在诊断和复发时负担最高。越来越多的 MM 患者在家中接受口服维持治疗药物。因此，对药物依从性和患者报告的结果（包括 HRQoL）进行纵向监测，可以了解疾病状况、治疗耐受性和对护理的满意度。数字健康技术，包括远程医疗、移动医疗和可穿戴设备，有望成为现代医疗保健的重要组成部分，部分原因是 COVID-19 大流行导致远程医疗需求激增。尽管文献中有许多关于数字健康技术在其他类型癌症中的应用报告，但较少的研究报告其在 MM 中的应用。在当前的叙述性综述中，我们调查了数字健康在 MM 中的应用。虽然有证据表明其中一些与改善健康结果相关，但存在必须解决的挑战，以确保更广泛的采用。这些挑战包括患者和医疗保健提供者需要提高认识、典型的老年 MM 患者缺乏获取途径、缺乏随机临床试验以及与电子健康记录等当前工作流程的集成度低。在总结了可能使 MM 患者受益的技术之后，我们最后描述了我们对如何将它们整合到患者旅程的每个阶段的设想。
