Geriatric assessment-guided interventions for older adults with multiple myeloma: A feasibility and acceptability study

Christopher E Jensen; Allison M Deal; Kirsten A Nyrop; Maya Logan; Nicholas J Mangieri; Martha D Strayhorn; Jordan Miller; Hyman B Muss; Eben I Lichtman; Samuel M Rubinstein; Sascha A Tuchman

doi:10.1016/j.jgo.2023.101680

Geriatric assessment-guided interventions for older adults with multiple myeloma: A feasibility and acceptability study

J Geriatr Oncol. 2024 Mar;15(2):101680. doi: 10.1016/j.jgo.2023.101680. Epub 2023 Dec 16.

Authors

Affiliations

¹ Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Physicians Office Building, CB# 7305, Chapel Hill, NC 27599, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: christopher.jensen@unchealth.unc.edu.
² Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: allison_deal@med.unc.edu.
³ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA; Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Physicians Office Building, CB# 7305, Chapel Hill, NC 27599, USA. Electronic address: kirsten_nyrop@med.unc.edu.
⁴ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: mayal99@live.unc.edu.
⁵ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: nicholas_mangieri@med.unc.edu.
⁶ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: dell_strayhorn@med.unc.edu.
⁷ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: jordan.miller@unchealth.unc.edu.
⁸ Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA; Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Physicians Office Building, CB# 7305, Chapel Hill, NC 27599, USA. Electronic address: hyman_muss@med.unc.edu.
⁹ Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Physicians Office Building, CB# 7305, Chapel Hill, NC 27599, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: eben_lichtman@med.unc.edu.
¹⁰ Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Physicians Office Building, CB# 7305, Chapel Hill, NC 27599, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: samuel_rubinstein@med.unc.edu.
¹¹ Division of Hematology, Department of Medicine, University of North Carolina at Chapel Hill, 170 Manning Drive, Physicians Office Building, CB# 7305, Chapel Hill, NC 27599, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Drive, Chapel Hill, NC 27599, USA. Electronic address: sascha_tuchman@med.unc.edu.

PMID: 38104482
PMCID: PMC10922464 (available on 2025-03-01)
DOI: 10.1016/j.jgo.2023.101680

Abstract

Introduction: Geriatric assessment (GA)-guided supportive care programs have been successful in improving treatment outcomes for older adults with solid-organ cancers. This study aimed to evaluate the feasibility of a GA-guided supportive care program among older adults treated for multiple myeloma (MM).

Materials and methods: The study utilized an existing registry of adults with plasma cell disorders at the University of North Carolina. Patients with MM, aged 60 or older, and having a GA-identified deficit in one or more problem area were offered referrals to supportive care resources during routine visits. Problem areas included physical function deficits, polypharmacy, and anxiety or depression. Patients with physical function deficits were offered referral to physical therapy (PT), those with polypharmacy to an Oncology Clinical Pharmacist Practitioner (CPP), and those with mental health symptoms to the Comprehensive Cancer Support Program (CCSP).

Results: Of the 58 individuals identified as having at least one deficit on the GA, PT was the most commonly identified relevant resource (79%), followed by CPP visits (57%). Among individuals that were offered referral(s) to at least one new supportive care resource, the acceptance rate was 50%. Referral acceptance rates were highest among those recommended for a CPP visit (55% of those approached) and lowest for CCSP (0%).

Discussion: The study examined the feasibility and acceptability of a referral program for supportive care resources among older adults with MM who have deficits on GA. The most commonly identified deficit was physical functioning, followed by polypharmacy and mental health. The study found that physical interventions and referrals to CPPs were the most accepted interventions. However, the low proportion of patients who accepted physical therapy referrals indicates the need for tailored and more personalized approaches. Further research is needed to explore the feasibility and impact of supportive care referral programs for older adults with MM.

Keywords: Function; Geriatric assessment; Multiple myeloma; Polypharmacy.

MeSH terms

Aged
Feasibility Studies
Geriatric Assessment
Humans
Medical Oncology
Mental Health
Multiple Myeloma* / therapy
Neoplasms* / therapy

Abstract

MeSH terms

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