Abstract

Objective: To evaluate the impact of a patient-centered program on intravenous (IV) therapy compliance among patients with multiple myeloma

Background: Treatment noncompliance can have devastating consequences on the clinical prognosis of patients with multiple myeloma. Both environmental and psychological factors are often the cause of noncompliance and can be addressed through, psychosocial support, individualized condition and product education plans, and health coaching techniques; which are all known to positively influence patient behavior. Using Oncology Certified, Telehealth Registered Nurses (OCN) within a patient-centered support program, Lash Group provides enrolled patients with emotional and educational support necessary to overcome noncompliance to treatment. Quantifying the impact of a patient-centered program on patients' compliance with treatment may aid stakeholders while optimizing their treatment of multiple myeloma.

Methods:

DATA COLLECTION: Electronic medical record data from the International Oncology Network (ION) was used to identify patients with a diagnosis of multiple myeloma (ICD-9-CM: 203.0) receiving IV therapy, between January 1, 2012 and December 31, 2015. Patients were classified into 1 of 2 study cohorts: patients enrolled within Lash Group's patient support services program and patients not enrolled in the patient support services program. Compliance measures (including length of therapy, number of infusions, and time between administrations) were captured during a follow-up period of 12-months, and compared across study cohorts using standardized differences (std diff). Standardized differences greater than 0.10 were considered to demonstrate significant variance in measures between patients included and not included in the patient-centered program.

PATIENT SUPPORT PROGRAM: Patients enrolled into Lash Group's patient-centered program received individualized support during their time on therapy. OCN Telehealth nurses used a combination of techniques including segmentation (to truly understand where patients are in their care), motivational interviewing (to create an empathic environment for which patients and nurses are able to uncover both educational and emotional needs), and educational resources to build condition and product knowledge for patient engagement. Patients were provided follow-up calls as directed by their treatment cycles and individual psychosocial needs.

Results: A total of 476 patients with multiple myeloma receiving IV therapy were included in the analysis, of which 129 (27%) were enrolled in Lash Group's patient-centered program. The mean age (±SD) of the final sample was 70.5(±10.4) years and 56.3% were male. Individuals enrolled in the patient-centered program on an average were younger (68.8 vs 71.1; std diff=-0.222), and larger proportion were male (59.7% vs 55.0%, std diff=0.0941). Patients enrolled in the patient-centered program had higher number of IV infusions on average (27.6 vs 22.9; std diff=0.1662) and longer mean length of therapy (154.1 vs 144.9; std diff=0.0478) although not statistically significant. Furthermore, the average time between administrations was shorter for patient-centric program participants (5.0 vs 6.0 days; std diff=-0.2679).

Conclusion: Using a patient-centered approach to supporting enrolled patients receiving IV therapy for multiple myeloma, resulted in better compliance outcomes as quantified by a higher number of IV infusions and a longer mean length of therapy. These study results highlight the effectiveness of patient-centered support programs as a means to improve treatment compliance through emotional and educational support during the therapeutic journey.

Disclosures

No relevant conflicts of interest to declare.

Author notes

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Asterisk with author names denotes non-ASH members.