NP-109: Improving long-term quality of life for patients living with multiple myeloma: a service evaluation

Abstract

<h3>Background</h3> Multiple myeloma (MM) is an incurable malignancy of the bone marrow. With improving survivorship patients are developing late effects and long-term consequences due to the treatments, alongside the disease itself. The 2017 guidance for screening and management of late and long-term consequences does not suggest where in the MM pathway this screening should be. <h3>Methods</h3> A quantitative, formative service evaluation using audit of the current screening and a correlational design, using one-way MANOVA evaluating the effect the stage of pathway has on symptom burden and distress. Symptom burden is assessed using the palliative outcome score MY-POS and distress using the distress thermometer. <h3>Results</h3> Patients (N=60) are currently frequently screened for adjusted calcium (96%), urea and electrolytes (96%), liver function tests (90%) and blood pressure (62%). LH/FSH (0%), testosterone (10%), oestrogen (0%), T-SAT (30%), Vitamin D (15%) and BNP (3%) are least likely to be screened. Completed questionnaires (N=223) demonstrated that frequently reported symptoms were pain (76.2%), weakness or lack of energy (86.1%), drowsiness (69.1%), poor mobility (70.1%) and tingling in the hands and feet (65.5%). Distress is perceived higher by those patients on treatment (M=4.01, SD=2.486). Higher levels of distress were demonstrated by patients post first line (M=3.33, SD=2.446) and post third line (M=4.6, SD=2.510). MANOVA analysis demonstrated an effect on overall wellbeing of the patients in relation to position in the treatment pathway (F=13.35, p=<0.005) <h3>Discussion</h3> Screening and management of late effects and long-term consequence can improve quality of life. This evaluation has demonstrated the need for formal screening and management of these complications from diagnosis. Evaluation of symptoms and distress in the pathway has demonstrated that assessment at diagnosis, at the end of first line treatment or one year after starting a continuous treatment and repeated annually from when patients start third line treatment will improve QOL.