TY - JOUR
T1 - Early palliative care versus usual haematological care in multiple myeloma
T2 - retrospective cohort study
AU - Giusti, Davide
AU - Colaci, Elisabetta
AU - Pioli, Valeria
AU - Banchelli, Federico
AU - MacCaferri, Monica
AU - Leonardi, Giovanna
AU - Marasca, Roberto
AU - Morselli, Monica
AU - Forghieri, Fabio
AU - Bettelli, Francesca
AU - Cuoghi, Angela
AU - Bresciani, Paola
AU - Messerotti, Andrea
AU - Gilioli, Andrea
AU - Candoni, Anna
AU - Cassanelli, Luca
AU - Sbadili, Elena
AU - Bassoli, Ilaria
AU - Longo, Giuseppe
AU - Gilioli, Fabio
AU - Borelli, Eleonora
AU - Bigi, Sarah
AU - D'Amico, Roberto
AU - Porro, Carlo Adolfo
AU - Odejide, Oreofe
AU - Zimmermann, Camilla
AU - Efficace, Fabio
AU - Bruera, Eduardo
AU - Luppi, Mario
AU - Bandieri, Elena
AU - Potenza, Leonardo
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023
Y1 - 2023
N2 - Objectives: Although early palliative care (EPC) is beneficial in acute myeloid leukaemia, little is known about EPC value in multiple myeloma (MM). We compared quality indicators for palliative and end-of-life (EOL) care in patients with MM receiving EPC with those of patients who received usual haematological care (UHC). Methods: This observational, retrospective study was based on 290 consecutive patients with MM. The following indicators were abstracted: providing psychological support, assessing/managing pain, discussing goals of care, promoting advance care plan, accessing home care services; no anti-MM treatment within 14 and 30 days and hospice length of stay >7 days before death; no cardiopulmonary resuscitation, no intubation, <2 hospitalisations and emergency department visits within 30 days before death. Comparisons were performed using unadjusted and confounder-adjusted regression models. Results: 55 patients received EPC and 231 UHC. Compared with UHC patients, EPC patients had a significantly higher number of quality indicators of care (mean 2.62±1.25 vs 1.12±0.95; p<0.0001)); a significant reduction of pain intensity over time (p<0.01) and a trend towards reduced aggressiveness at EOL, with the same survival (5.3 vs 5.46 years; p=0.74)). Conclusions: Our data support the value of integrating EPC into MM routine practice and lay the groundwork for future prospective comparative studies.
AB - Objectives: Although early palliative care (EPC) is beneficial in acute myeloid leukaemia, little is known about EPC value in multiple myeloma (MM). We compared quality indicators for palliative and end-of-life (EOL) care in patients with MM receiving EPC with those of patients who received usual haematological care (UHC). Methods: This observational, retrospective study was based on 290 consecutive patients with MM. The following indicators were abstracted: providing psychological support, assessing/managing pain, discussing goals of care, promoting advance care plan, accessing home care services; no anti-MM treatment within 14 and 30 days and hospice length of stay >7 days before death; no cardiopulmonary resuscitation, no intubation, <2 hospitalisations and emergency department visits within 30 days before death. Comparisons were performed using unadjusted and confounder-adjusted regression models. Results: 55 patients received EPC and 231 UHC. Compared with UHC patients, EPC patients had a significantly higher number of quality indicators of care (mean 2.62±1.25 vs 1.12±0.95; p<0.0001)); a significant reduction of pain intensity over time (p<0.01) and a trend towards reduced aggressiveness at EOL, with the same survival (5.3 vs 5.46 years; p=0.74)). Conclusions: Our data support the value of integrating EPC into MM routine practice and lay the groundwork for future prospective comparative studies.
KW - haematological disease
KW - pain
KW - quality of life
KW - supportive care
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U2 - 10.1136/spcare-2023-004524
DO - 10.1136/spcare-2023-004524
M3 - Article
C2 - 37751995
AN - SCOPUS:85173189631
SN - 2045-435X
JO - BMJ Supportive and Palliative Care
JF - BMJ Supportive and Palliative Care
M1 - spcare-2023-004524
ER -