University College London Cancer Institute, 72 Huntley Street, London, WC1E 6DD, UK.
University College London Institute of Epidemiology & Health Care, 1-19 Torrington Place, London, WC1E 7HB, UK.
Support Care Cancer. 2023 Jan 21;31(2):127. doi: 10.1007/s00520-023-07587-9.
Patients with multiple myeloma suffer from disease-related complications such as bone destruction, toxicities from repeated therapies and age-related co-morbidities. With improved treatment options, patients are living longer and have specific survivorship needs such as low exercise levels that need to be addressed. In this study, we designed, implemented and evaluated a multidisciplinary team (MDT) myeloma clinic that provided participants with tailored exercise and lifestyle advice.
The Promoting Individualised Self-Management and Survivorship (PrISMS) clinic was set up in two UK myeloma centres. This remote MDT clinic comprised of a doctor, a nurse specialist and a physiotherapist. Patients were required to complete blood tests and a questionnaire about their symptoms and concerns before each consultation. Patient-reported outcome measures were captured using validated questionnaires. Patient feedback was collected using a specially designed survey and structured telephone interviews.
Sixty-one patients were enrolled in the pilot clinic with 210 consultations held during the study period. Nine patients had disease progression and were referred safely back to face-to-face clinics. There was a significant improvement in patients' exercise score (p = 0.02) after PrISMS clinic. Patient satisfaction was high, with 83% feeling more confident in self-managing myeloma after PrISMS clinic.
PrISMS clinic is safe and feasible, with high patient compliant and acceptability. It empowers patients to self-manage their condition and encourages physical activity, which is associated with improved quality of life and fatigue level. Future randomised controlled trials will help to confirm its benefits on patient clinical outcomes and cost-effectiveness.
多发性骨髓瘤患者患有与疾病相关的并发症,如骨破坏、反复治疗的毒性和与年龄相关的合并症。随着治疗选择的改善,患者的寿命延长,并且有特定的生存需求,如运动水平低,需要加以解决。在这项研究中,我们设计、实施和评估了一个多学科团队(MDT)骨髓瘤诊所,为参与者提供量身定制的运动和生活方式建议。
促进个体化自我管理和生存(PrISMS)诊所设立在英国的两个骨髓瘤中心。这个远程 MDT 诊所由一名医生、一名护士专家和一名物理治疗师组成。患者在每次就诊前需要完成血液检查和一份关于他们的症状和担忧的问卷。患者报告的结果测量采用经过验证的问卷进行采集。使用专门设计的调查和结构化电话访谈收集患者反馈。
61 名患者参加了试点诊所,在研究期间共进行了 210 次就诊。9 名患者疾病进展,安全地转回面对面诊所。在接受 PrISMS 诊所治疗后,患者的运动评分显著改善(p=0.02)。患者满意度很高,83%的患者在接受 PrISMS 诊所治疗后对自我管理骨髓瘤更有信心。
PrISMS 诊所是安全可行的,具有较高的患者依从性和可接受性。它使患者能够自我管理病情,并鼓励身体活动,这与改善生活质量和疲劳水平有关。未来的随机对照试验将有助于证实其对患者临床结果和成本效益的益处。