PB2265 THE RELATIONSHIPS BETWEEN QUALITY OF LIFE AND DISEASE MANAGEMENT AWARENESS, PREFERENCES AND SATISFACTION: NATION‐WIDE SURVEY OF MULTIPLE MYELOMA PATIENTS IN BELARUS
Authors: Iskrou I. , Kashkevich V. , Papok V. , Matsiushonak A. , Golubev S. 
Published: June 2019

Background:

Health‐related quality of life (QoL) is an important humanistic outcome of multiple myeloma (MM) management. While QoL in MM is studied in controlled clinical trials, predominantly in the European Union communities, QoL level and components data are scarcer in real‐world clinical settings. Moreover, QoL level and changes to QoL under different treatment modalities may be confounded by other patient factors which require clarification.

Aims:

To cover the information gaps regarding the level and patient‐ and disease‐related predictors of QoL in MM patients residing in Belarus.

Methods:

A cross‐sectional survey of a country‐representative sample of 300 MM patients of Belarus was performed. The survey consisted of 42 multiple choice questions including the whole EORTC QoL Core Questionnaire (EORTC QLQ‐C30, version 3.0), 3 questions from EORTC QoL Questionnaire – MM Module (EORTC QLQ‐MY20) related to attitude toward the disease course and perspectives, and additional items related to patients’ preference toward place and route of drug administration, their disease awareness, and overall satisfaction with healthcare services. Descriptive analyses were conducted.

Results:

Global health status/QoL of MM patients was 55.3 (95%CI 52.8 – 57.8). The main components deteriorating QoL were physical functioning, fatigue, pain and sleep disorders. QoL functional scales scores decreased and QoL symptomatic scales scores increased across age and disease duration distributions, with the QoL scores drop in patients with 3‐4 years of disease duration. Higher scores for almost all QoL functional domains were noted in patients preferring oral treatment. Majority (54%) welcomed combination (intravenous + per os) therapy, but only 28% of patients preferred sole parenteral administration of drugs. 72% of respondents considered the quality of diagnostics & treatment as good or excellent, while 45% preferred to be treated in ambulatory settings and/or at home. Global and functional but not symptomatic QoL scores were directly related to the level of patients’ satisfaction with disease management. Worries about dying were revealed as a predominant negative factor for all EORTC QLQ‐C30 scores. The level of patients’ awareness (on their health status and the course of the disease, possible treatment options and side effects) significantly and positively related to their QoL levels.

Summary/Conclusion:

QoL of MM patients in Belarus corresponds to EORTC reference data which makes possible inter‐country comparisons and translation of humanistic outcomes of clinical trials. MM duration, patient attitude toward the disease course and overall patient satisfaction with healthcare services are important predictors of QoL. The evidence suggests that successful patient education activities per se can improve QoL of MM patients and hence their engagement in ambulatory treatment modalities. It should be better addressed in quality control and improvement measures of MM management.