Functional Status Associations With Treatment Receipt and Outcomes Among Older Adults Newly Diagnosed With Multiple Myeloma.

Autor:	Jensen CE; Division of Hematology, University of North Carolina School of Medicine, Chapel Hill, NC., Kuo TM; Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC., LeBlanc MR; University of North Carolina School of Nursing, Chapel Hill, NC., Baggett CD; Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC., Duchesneau ED; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC., Zhou X; Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC., Reeder-Hayes KE; Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.; Division of Oncology, University of North Carolina School of Medicine, Chapel Hill, NC., Lund JL; Cancer Information & Population Health Resource, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC.; Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC.
Jazyk:	angličtina
Zdroj:	JCO clinical cancer informatics [JCO Clin Cancer Inform] 2024 Feb; Vol. 8, pp. e2300214.
DOI:	10.1200/CCI.23.00214
Abstrakt:	Purpose: Multiple myeloma (MM) is a prevalent hematologic malignancy in older adults, who often experience physical disability, increased health care usage, and reduced treatment tolerance. Home health (HH) services are frequently used by this group, but the relationship between disability, HH use, and MM treatment receipt is unclear. This study examines the connections between disability, treatment receipt, and survival outcomes in older adults with newly diagnosed MM using a nationwide data set. Methods: The SEER-Medicare data set was used to identify adults aged 66 years and older diagnosed with MM from 2010 to 2017, who used HH services the year before diagnosis. Disability was assessed with the Outcome and Assessment Information Set, using a composite score derived from items related to ability to complete activities of daily living. Mortality, therapy receipt, and health care utilization patterns were evaluated. Results: Of 37,280 older adults with MM, 6,850 (18.2%) used HH services before diagnosis. Moderate disability at HH assessment resulted in similar MM-directed therapy receipt as mild disability, with comparable health care usage after diagnosis to severe disability. HH users had a higher comorbidity burden and higher mortality (adjusted risk ratio for 3-year mortality: 1.59 [95% CI, 1.55 to 1.64]). Severe functional disability before diagnosis was strongly related to postdiagnosis mortality. Conclusion: Among older adults with MM receiving HH services, disability is a predictor of early mortality. Moderately disabled individuals undergo similar therapy intensity as the mildly disabled but experience increased acute care utilization. Previous HH use could identify patients with MM requiring intensive support during therapy initiation.
Databáze:	MEDLINE
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