Abstract
Background: Multiple myeloma is associated with a higher
burden of disease than other haematological cancers.
To understand the determinants of low health-related quality
of life (HrQoL) or high cost/health care use could help
identify those patients at risk of developing a worse outcome
and target services towards them.
Aim: To systematically review, assess and analyse the
strength of association between different disease factors
and the outcomes HrQoL, cost and health care utilisation
in multiple myeloma.
Method: We searched Medline, Embase, PsycINFO,
Cinahl, Assia, the Cochrane library and NHS EED databases,
journals and citations using keywords/subject
headings for myeloma and QoL or cost/health care use.
Inclusion criteria: Studies reporting associations in samples
≥50% myeloma. Fisher’s z method for correlations and
random effects meta-analysis.
Results: Of 20,883 references, 43 studies with 4,960 participants
were included. None reported associations for
both outcomes. The largest effect sizes were found for
nutritional risk and fatigue (r=-0.51 and -0.54) associated
with worse HrQoL. Medium associations were reported
for other symptoms and biochemical parameters like
M-protein level, creatinine etc. High haemoglobin was a
moderate protective factor for HrQoL (r=0.39). Demographic,
disease- and treatment-related factors showed weak
associations only, except for response (r=0.29, 95%CI
0.24-0.34). Treatment-related factors were the main drivers
of cost (days in intensive care, laboratory procedures
(r=0.52)). Moderate associations were found for disease
stage, duration of maintenance treatment. A higher platelet
count was weakly associated with lower costs (r=-0.22,
95% CI:-0.38 to -0.05).
Conclusion: A model of predictors for HrQoL in myeloma
was developed. Early detection of those at risk for developing
worse HrQoL or higher cost/hospitalisation should
consider symptoms as well as biochemical factors and cannot
focus on response or treatment alone.
burden of disease than other haematological cancers.
To understand the determinants of low health-related quality
of life (HrQoL) or high cost/health care use could help
identify those patients at risk of developing a worse outcome
and target services towards them.
Aim: To systematically review, assess and analyse the
strength of association between different disease factors
and the outcomes HrQoL, cost and health care utilisation
in multiple myeloma.
Method: We searched Medline, Embase, PsycINFO,
Cinahl, Assia, the Cochrane library and NHS EED databases,
journals and citations using keywords/subject
headings for myeloma and QoL or cost/health care use.
Inclusion criteria: Studies reporting associations in samples
≥50% myeloma. Fisher’s z method for correlations and
random effects meta-analysis.
Results: Of 20,883 references, 43 studies with 4,960 participants
were included. None reported associations for
both outcomes. The largest effect sizes were found for
nutritional risk and fatigue (r=-0.51 and -0.54) associated
with worse HrQoL. Medium associations were reported
for other symptoms and biochemical parameters like
M-protein level, creatinine etc. High haemoglobin was a
moderate protective factor for HrQoL (r=0.39). Demographic,
disease- and treatment-related factors showed weak
associations only, except for response (r=0.29, 95%CI
0.24-0.34). Treatment-related factors were the main drivers
of cost (days in intensive care, laboratory procedures
(r=0.52)). Moderate associations were found for disease
stage, duration of maintenance treatment. A higher platelet
count was weakly associated with lower costs (r=-0.22,
95% CI:-0.38 to -0.05).
Conclusion: A model of predictors for HrQoL in myeloma
was developed. Early detection of those at risk for developing
worse HrQoL or higher cost/hospitalisation should
consider symptoms as well as biochemical factors and cannot
focus on response or treatment alone.
Original language | English |
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Pages (from-to) | 631-631 |
Number of pages | 1 |
Journal | Palliative Medicine |
Volume | 28 |
Issue number | 6 |
Publication status | Published - 2014 |