Healthcare resource utilisation associated with skeletal-related events in European patients with multiple myeloma: Results from a prospective, multinational, observational study

Eur J Haematol. 2018 May;100(5):479-487. doi: 10.1111/ejh.13044. Epub 2018 Mar 22.

Abstract

Objectives: Patients with multiple myeloma (MM) often experience debilitating skeletal-related events (SREs: pathologic fracture, radiation to bone [RB], surgery to bone [SB] or spinal cord compression [SCC]). This is the first comprehensive, prospective, observational analysis of healthcare resource utilisation (HRU), independently attributed to SREs by investigators, in patients with MM.

Methods: Eligible patients had lytic bone lesions, life expectancy ≥6 months, Eastern Cooperative Oncology Group performance status ≤2 and ≥1 SRE in the 97 days before enrolment. Data were collected retrospectively for 97 days before enrolment and prospectively for 18-21 months.

Results: Altogether, 153 patients were enrolled from Germany, Italy, Spain and the United Kingdom. Of the 281 observed SREs, 36.7% required inpatient stays (mean duration: 20.6 days per SRE [standard deviation (SD): 22.9]). SB and SCC were the SREs most likely to require stays (72.3% and 50.0% of SREs, respectively); SCC required the longest mean (SD) stay per event (40.5 [40.8] days). Overall, 179 SREs required outpatient visits; this was most likely for RB (74.8%) and least likely for non-vertebral fracture (50.0%).

Conclusions: All SREs were associated with substantial HRU; therefore, preventing SREs in MM will reduce the economic and resource burden on healthcare systems.

Keywords: advanced cancer; bone lesions; healthcare resource utilisation; multiple myeloma; observational research; skeletal-related events.

Publication types

  • Multicenter Study

MeSH terms

  • Ambulatory Care
  • Bone and Bones / pathology
  • Emergency Medical Services
  • Female
  • Fractures, Bone / diagnosis
  • Fractures, Bone / epidemiology*
  • Fractures, Bone / etiology*
  • Health Resources*
  • Home Care Services
  • Hospitalization
  • Humans
  • Male
  • Multiple Myeloma / complications*
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / therapy
  • Patient Acceptance of Health Care*
  • Prospective Studies
  • Radiotherapy / adverse effects
  • Radiotherapy / methods
  • Surgical Procedures, Operative