Ali Alobaidi1, Nadia A Nabulsi1, Brian Talon1, Alemseged A Asfaw1, Jifang Zhou1, Lisa K Sharp1, Karen Sweiss2, Pritesh R Patel3, Naomi Y Ko4, Brian C-H Chiu5, Gregory S Calip6,7. 1. Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA. 2. Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL, USA. 3. Division of Hematology and Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA. 4. Section of Hematology Oncology, Boston University School of Medicine, Boston, MA, USA. 5. Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA. 6. Department of Pharmacy Systems, Outcomes and Policy, Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, 833 S. Wood St. MC 871, Chicago, IL, 60612, USA. gcalip@uic.edu. 7. Division of Public Health Sciences, Epidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. gcalip@uic.edu.
Abstract
PURPOSE: To examine the impact of pre-diagnosis depressive symptoms and mental health-related quality of life (HRQOL) on survival among older patients with multiple myeloma (MM). METHODS: We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data resource. Patients aged 65 years and older diagnosed with first primary MM between 1998 and 2014 were identified, and presence of depressive symptoms was determined based on responses to 3 depression screening questions prior to MM diagnosis. Veterans RAND 12 mental component summary (MCS) scores were analyzed to evaluate mental HRQOL. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of all-cause and cancer-specific mortality. RESULTS: Of 522 patients, mean (SD) age at diagnosis was 76.9 (6.1) years and 158 (30%) reported depressive symptoms. Patients with depressive symptoms had a higher number of comorbid conditions and nearly all (84%) scored below the median MCS. Pre-diagnosis depressive symptoms were not associated with all-cause (HR = 1.01, 95% CI 0.79-1.29) or cancer-specific mortality (HR = 0.94, 95% CI 0.69-1.28). MM patients scoring in the second MCS tertile (vs the highest tertile) had a modestly increased risk of all-cause (HR = 1.19, 95% CI 0.91-1.55) and cancer-specific mortality (HR = 1.17, 95% CI 0.86-1.60), but these estimates were not statistically significant. CONCLUSION: Pre-diagnosis depressive symptoms and lower mental HRQoL did not impact survival among older MM patients. Highly prevalent depressive symptoms among older MM patients deserve clinical attention. Such efforts can inform clinicians in tailoring care for this vulnerable population.
PURPOSE: To examine the impact of pre-diagnosis depressive symptoms and mental health-related quality of life (HRQOL) on survival among older patients with multiple myeloma (MM). METHODS: We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data resource. Patients aged 65 years and older diagnosed with first primary MM between 1998 and 2014 were identified, and presence of depressive symptoms was determined based on responses to 3 depression screening questions prior to MM diagnosis. Veterans RAND 12 mental component summary (MCS) scores were analyzed to evaluate mental HRQOL. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of all-cause and cancer-specific mortality. RESULTS: Of 522 patients, mean (SD) age at diagnosis was 76.9 (6.1) years and 158 (30%) reported depressive symptoms. Patients with depressive symptoms had a higher number of comorbid conditions and nearly all (84%) scored below the median MCS. Pre-diagnosis depressive symptoms were not associated with all-cause (HR = 1.01, 95% CI 0.79-1.29) or cancer-specific mortality (HR = 0.94, 95% CI 0.69-1.28). MMpatients scoring in the second MCS tertile (vs the highest tertile) had a modestly increased risk of all-cause (HR = 1.19, 95% CI 0.91-1.55) and cancer-specific mortality (HR = 1.17, 95% CI 0.86-1.60), but these estimates were not statistically significant. CONCLUSION: Pre-diagnosis depressive symptoms and lower mental HRQoL did not impact survival among older MMpatients. Highly prevalent depressive symptoms among older MMpatients deserve clinical attention. Such efforts can inform clinicians in tailoring care for this vulnerable population.
Entities:
Keywords:
Cancer survival; Depression; Elderly; Mental health; Multiple myeloma
Authors: Nadia A Nabulsi; Khatija W Naing; Huiwen Deng; Jenilee Cueto; Alemseged A Asfaw; Colin C Hubbard; Jifang Zhou; Inyoung Lee; Debanjali Mitra; Gregory S Calip; Ernest H Law Journal: J Patient Exp Date: 2022-07-11