Contributions
Abstract: EP1052
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
Newly Diagnosed Multiple Myeloma (NDMM) is recognised as a source of significant morbidity and mortality. Though current therapies have been associated with substantial improvements in patient outcomes for both transplant eligible (TE) and non-transplant eligible (NTE) individuals, the magnitude of the burden of illness (BoI) among NDMM patients, and their caregivers, in the first year after diagnosis has yet to be defined.
Aims
To quantify the BoI in TE and NTE NDMM patients, and their caregivers at 3 timepoints: pre-treatment (TP0), at 3 months (TP3) and at 12 months post-treatment (TP12).
Methods
A prospective, longitudinal, observational NDMM study was conducted amongst TE and NTE patients, and their caregivers, from France, Germany, Italy, and Spain between January 2019 and January 2021. Participants were recruited through their haematologist/haemato-oncologist. A structured, online questionnaire incorporating standardised assessment tools for measuring disease burden, including direct costs, indirect costs, and health-related quality of life (HRQoL) was used. Where possible, respondents completed all timepoints; however, some additional recruits were included at TP3 and TP12 to account for drop-outs. Descriptive statistics were performed and informed consent was obtained.
Results
Across the 3 timepoints, 160-190 NDMM patients [majority older than 65 years of age; multimorbid; self-described as relatively healthy; not working; living with the caregiver] answered the questionnaire. Throughout the 12 months, patients progressively lost independence to perform daily activities [IADL scores]. Median 3-month direct medical costs peaked at 3 months, being significantly higher amongst TE patients than NTE patients, due to increased testing and overnight hospital stays. Specialist consultations and hospital admissions were the greatest cost component amongst TE and NTE patients, respectively. In addition, home adaptations raised out-of-pocket expenditures amongst some NTE patients. Although always a minority, the share of working patients declined across the 12 months; those still describing themselves as working spent a median zero hours in the office at all timepoints, with associated costs for the employer. After a partial recovery at TP3, the numeric rating of pain intensity (mean) raised, more significantly among NTE patients. Accordingly, opioid utilisation increased from TP0 to TP12, particularly for NTE patients. Despite this, overall health status and HRQoL [EORTC QLQ-C30] remained stable with average scores over time. Across timepoints, 122-131 caregivers [patient’s partner or adult child; self-rated good health; not employed; caring for the patient more than 4 days a week] answered the questionnaire. Mean self-rated burden score rose over the 12 months. By TP12, half of caregivers developed stress, anxiety or depression related to the patient’s NDMM. Though most employed caregivers continue to be able to work, productivity was low at TP0 with a trend to recovering at TP12. Caregivers of NDMM NTE patients reported greater time burden compared to TE individuals. As seen with the patients, caregivers’ HRQoL remained stable over time [CarerQoL 7D score].
Conclusion
NDMM is highly burdensome for patients and caregivers in the first year after treatment initiation. NTE patients experience greater pain and are more dependent on caregivers than TE patients. Despite the economic, physical, and emotional burden, HRQoL remains stable possibly indicating resilience and illness adjustment amongst patients and caregivers.
Keyword(s): Cost analysis, Multiple myeloma, Quality of life
Abstract: EP1052
Type: E-Poster Presentation
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
Newly Diagnosed Multiple Myeloma (NDMM) is recognised as a source of significant morbidity and mortality. Though current therapies have been associated with substantial improvements in patient outcomes for both transplant eligible (TE) and non-transplant eligible (NTE) individuals, the magnitude of the burden of illness (BoI) among NDMM patients, and their caregivers, in the first year after diagnosis has yet to be defined.
Aims
To quantify the BoI in TE and NTE NDMM patients, and their caregivers at 3 timepoints: pre-treatment (TP0), at 3 months (TP3) and at 12 months post-treatment (TP12).
Methods
A prospective, longitudinal, observational NDMM study was conducted amongst TE and NTE patients, and their caregivers, from France, Germany, Italy, and Spain between January 2019 and January 2021. Participants were recruited through their haematologist/haemato-oncologist. A structured, online questionnaire incorporating standardised assessment tools for measuring disease burden, including direct costs, indirect costs, and health-related quality of life (HRQoL) was used. Where possible, respondents completed all timepoints; however, some additional recruits were included at TP3 and TP12 to account for drop-outs. Descriptive statistics were performed and informed consent was obtained.
Results
Across the 3 timepoints, 160-190 NDMM patients [majority older than 65 years of age; multimorbid; self-described as relatively healthy; not working; living with the caregiver] answered the questionnaire. Throughout the 12 months, patients progressively lost independence to perform daily activities [IADL scores]. Median 3-month direct medical costs peaked at 3 months, being significantly higher amongst TE patients than NTE patients, due to increased testing and overnight hospital stays. Specialist consultations and hospital admissions were the greatest cost component amongst TE and NTE patients, respectively. In addition, home adaptations raised out-of-pocket expenditures amongst some NTE patients. Although always a minority, the share of working patients declined across the 12 months; those still describing themselves as working spent a median zero hours in the office at all timepoints, with associated costs for the employer. After a partial recovery at TP3, the numeric rating of pain intensity (mean) raised, more significantly among NTE patients. Accordingly, opioid utilisation increased from TP0 to TP12, particularly for NTE patients. Despite this, overall health status and HRQoL [EORTC QLQ-C30] remained stable with average scores over time. Across timepoints, 122-131 caregivers [patient’s partner or adult child; self-rated good health; not employed; caring for the patient more than 4 days a week] answered the questionnaire. Mean self-rated burden score rose over the 12 months. By TP12, half of caregivers developed stress, anxiety or depression related to the patient’s NDMM. Though most employed caregivers continue to be able to work, productivity was low at TP0 with a trend to recovering at TP12. Caregivers of NDMM NTE patients reported greater time burden compared to TE individuals. As seen with the patients, caregivers’ HRQoL remained stable over time [CarerQoL 7D score].
Conclusion
NDMM is highly burdensome for patients and caregivers in the first year after treatment initiation. NTE patients experience greater pain and are more dependent on caregivers than TE patients. Despite the economic, physical, and emotional burden, HRQoL remains stable possibly indicating resilience and illness adjustment amongst patients and caregivers.
Keyword(s): Cost analysis, Multiple myeloma, Quality of life