Effects of early palliative care integration on patients with newly diagnosed multiple myeloma

• Published in: Supportive care in cancer Vol. 32; no. 7; p. 468
• Main Authors: Samala, Renato V., Nurse, Daniel P., Chen, Xiaoying, Wei, Wei, Crook, Jasmine J., Fada, Sherry D., Valent, Jason
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-07-2024; Springer Nature B.V
• Subjects: Adult; Aged; Anxiety - etiology; Clinical outcomes; Cohort Studies; Depression - etiology; Female; Humans; Male; Medical diagnosis; Medicine; Medicine & Public Health; Middle Aged; Multiple myeloma; Multiple Myeloma - psychology; Multiple Myeloma - therapy; Nursing; Nursing Research; Oncology; Pain; Pain Medicine; Palliative care; Palliative Care - methods; Patient care planning; Prospective Studies; Quality of Life; Rehabilitation Medicine; Palliative care; Early palliative care; Palliative medicine; Symptomatic multiple myeloma; Multiple myeloma
• DOI: 10.1007/s00520-024-08665-2
• EISSN: 1433-7339
• ISSN: 0941-4355; 1433-7339

Purpose
While numerous studies underscore the benefits of early palliative care (EPC) for patients with solid tumors, its effects on patients with multiple myeloma (MM) are not as widely known. This study aims to determine the effects of EPC integration on patients with newly diagnosed symptomatic MM and the feasibility of this approach.
Methods
This prospective cohort study enrolled patients within eight weeks of diagnosis. Participants met with a palliative care team monthly for 12 months. Functional Assessment of Cancer Therapy-General (FACT-G) plus Multiple Myeloma Subscale (FACT-MM), and Hospital Anxiety and Depression Scale (HADS) were administered upon enrollment and every three months. Proportion of completed visits and assessments determined the feasibility of EPC.
Results
Of the twenty participants enrolled from January 2020 to November 2022, median age was 65 (range 40, 77), 15 (75%) were female, 15 (75%) were white, 65% completed assessments at six months, and 60% at 12 months. The following measures significantly improved at 12 months versus baseline: FACT-G scores increased by 15.1 points (adjusted 95% CI: 2.2–28.1, adjusted
p
 = 0.02); Functional Well-Being scores increased by 6.0 points (adjusted 95% CI: 1.1–10.9, adjusted
p
 = 0.01); and Pain Subscale scores increased by 3.4 points (adjusted 95% CI: 0.5–6.4, adjusted
p
 = 0.02). Depression and anxiety scores did not significantly change over time.
Conclusion
Functional well-being, pain experience and overall QOL improved in a cohort of patients with newly diagnosed MM after 12 months of EPC involvement. Although monthly visits seemed feasible, the findings suggest that further research is needed to explore the optimal timing of palliative care interventions in the MM trajectory.
Trial registration
ClinicalTrials.gov ID NCT04248244 (Registration Date: January 30, 2020).