The following is a summary of “Access to palliative care in patients with multiple myeloma in the USA: A National Cancer Database (NCDB) analysis of years 2004-2020.,” published in the 2024 ASCO Annual Meeting under the issue of Oncology by Saba et al.

While palliative care (PC) helps improve the quality of life for patients with multiple myeloma (MM), real-world access and use need further study in the diverse population.

Researchers conducted a retrospective study to identify disparities in PC access for patients with MM in the US by race, ethnicity, and socioeconomic factors.

They utilized the NCDB to identify 202,949 patients with MM diagnosed from 2004 to 2020. Multivariate logistic regression analysis was conducted with SAS version 9.4 to determine independent factors of PC access.

The results showed an analysis of 202,949 patients with MM revealed significant disparities in PC access. Female patients had lower PC odds (OR: 0.94) compared to males, and Black patients (OR: 0.80) and other racial groups (OR: 0.84) had lower odds compared to White patients. Hispanic patients had lower PC utilization (OR: 0.84) compared to non-Hispanics (P<0.0001). Patients diagnosed in earlier years (2004-2007) had higher PC odds (OR: 1.12, P<0.0001), while those in 2008-2011 (OR: 0.93, P=0.0009) and 2012-2015 (OR: 0.87, P<0.0001) had lower odds compared to 2016-2020. Academic facilities had lower PC odds than non-academic ones (OR: 0.78, P<0.0001). 

Patients with no insurance (OR: 1.40, P<0.0001), Medicaid (OR: 1.17, P<0.0001), or other government insurance (OR: 1.38, P<0.0001) had higher PC odds compared to those with private insurance. Lower-income households (<$38,000, $38,000-$47,999, $48,000-$62,999) had higher PC odds compared to those with incomes >$63,000 (all P<0.0001). Areas with higher percentages of individuals without a high school degree (21%, OR: 0.83, P<0.0001; 13.0%-20.9%, OR: 0.94, P=0.0222) had lower PC odds than areas with <7.0%. Greater distance to treatment facilities (>30 miles) reduced PC odds compared to shorter distances (<10 miles) (OR: 0.83, P<0.0001). A Charlson-Deyo score of 1 increased PC odds compared to a score of 0 (OR: 1.12, P<0.0001).

Investigators concluded that significant disparities in PC access and utilization exist for patients with MM, with race, ethnicity, and gender influencing the inequalities.

Source: meetings.asco.org/abstracts-presentations/232795