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The study found an association between increased pain levels in patients with multiple myeloma and decreased health-related quality of life.
Pain in multiple myeloma may be the most important clinical manifestation during the development of the disease. The main causes are twofold, on the one hand, the destruction of bones due to disease, secondary and pathological fractures, or pain due to excessive tension of local masses. On the other hand, it is pathological causes, such as pain caused by compression fractures of the spinal cord, spine or compression of nerves by local masses.
Health-related quality of life (HRQOL) is a geriatric term published in 2017. It refers to the subjective satisfaction of an individual's health status (including physiological functions, psychological abilities, and social functions) under the influence of illness and injury, medical intervention, aging, and changes in the social environment, as well as subjective satisfaction associated with their economic, cultural background and value orientation, and is a classification of quality of life.
According to the results of a real-world study published in Cancer Reports, the higher the level of pain reported by patients with multiple myeloma, the worse their health-related quality of life (HRQOL) became. Specifically, the increase in pain severity from "none" to "severe" was associated with a statistically significant decrease in overall HRQOL in patients with multiple myeloma (average score 70.2-33.3; P
Patients with symptomatic multiple myeloma aged 18 years or older who receive first- or second-line and follow-up treatment voluntarily participate in questionnaires to rate the severity of their pain. The question for the questionnaire reads: "Please tick the box that best describes your current level of pain." Options include No Pain, Mild Pain, Moderate Pain, and Severe Pain.
In the study, patients' responses to a single pain severity question were consistent with the results of the European Five-Dimensional Health Scale (EQ-5D-5L) and the European Cancer Research and Treatment Organization Scale (EORTC QLQ).
From November 2017 to February 2018, a total of 330 patients with multiple myeloma were included in this study. The majority of patients were from Germany (80.9%), with 62.7% of women and 65.5% of patients retired at the time of the survey. The median age for all patients was 70 years and the median time between diagnosis of the disease and investigation was 0.96 years.
87.6% of patients reported bone pain, and 76.4% of patients reported bone pain or pain at a non-specific site. The majority (72.1%) of patients also reported spinal pain, with bone pain in other areas occurring in the hip (56.1%) and chest/ribs (33.3%). At the time of the survey, 22.0% of patients self-reported no pain, 48.8% had mild pain, 24.6% had moderate pain, and 4.6% had severe pain. Most patients who reported any severe pain at this time experienced bone pain in the 7 days prior to their investigation.
The researchers reported that the average scores on the EORTC QLQ-C30 scale varied with pain severity (from painless to severe pain), which included physical (82.7 to 35.11), social (81.1 to 44.4), emotional (78.1 to 48.3), and role functional areas (79.5 to 38.9) (P
However, the researchers note that for data obtained from small samples, such as those from the severe pain group, studies of larger samples are needed in the future to confirm.
Regarding the clinical significance of the study, the researchers concluded: "This simple and straightforward approach to understanding the severity of pain can simplify and speed up HRQOL assessment, and can also guide physicians in choosing treatment options to reduce and relieve pain and improve HRQOL in patients with multiple myeloma." ”
About EQ-5D-5L (EuroQol Five Dimensions Questionnaire): European five-dimensional health scale
Developed by the European Society for the Quality of Life (EuroQol), it is a standardized scale for measuring health status. The EQ-5D Series Scale is designed to describe and evaluate the health status of patients in various disease areas. This series of scales has been widely used in clinical trials, population studies and has been proven to have good reliability, validity and sensitivity in a variety of disease areas and populations.
About EORTC QLQ-C30: Quality of Life Core Questionnaire Scale
The core scale in the quality of life measurement scale system developed by the European Organization for Cancer Research and Treatment (EORTC) for cancer patients. The scale has a total of 30 items, including 5 functional scales (physical function, role function, cognitive function, emotional function, social function), 3 symptom scales (fatigue, pain, nausea and vomiting), 6 individual measurement items (dysphagia, loss of appetite, sleep disorders, constipation, diarrhea, economic difficulties), and 1 patient self-assessment item (overall health status). The original scores of each item need to be converted into a standardized score of 0 to 100 by a linear formula, and the higher the score of each functional dimension, the better the surface functional state; the higher the score of the symptom scale and the individual item, indicating that the more obvious the symptoms and the poorer the quality of life.