Assessing the Effect of Adherence on Patient-reported Outcomes and Out of Pocket Costs Among Patients With Multiple Myeloma

Shaloo Gupta, Safiya Abouzaid, Ryan Liebert, Kejal Parikh, Brian Ung, Aaron Rosenberg

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


It is unclear how medication adherence affects the burden of multiple myeloma (MM). Overall, 162 adults with MM completed an online survey. Better medication adherence related to less impairment to work productivity and functioning, lower out of pocket costs, and fewer office visits. With increased survival, considering the quality of life for patients with MM will be essential. Background: The present study characterized the effect of multiple myeloma (MM) on work productivity, health care resource usage, and out of pocket costs (OOPCs) and examined the association of adherence with quality of life (QoL) and productivity loss. Materials and Methods: The present cross-sectional study included 162 patients categorized by their 4-item Morisky Medication Adherence Scale (MMAS-4) score (4 vs. ≤ 3). Online surveys included the Work Productivity and Activity Impairment questionnaire, Functional Assessment of Cancer Therapy–Multiple Myeloma (FACT-MM), and MM-specific questions. Results: On average, patients reported FACT-MM scores of 98.5 ± 29.3, absenteeism of 18.3% ± 17.8%, presenteeism of 51.8% ± 30.2%, overall work productivity impairment of 57.3% ± 31.7%, and activity impairment of 49.9% ± 29.5% in the previous 7 days. During the previous 3 months, the mean OOPCs were $709 ± $1307; prescription medications accounted for 55% of these costs. Patients attended 4.1 ± 4.6 visits to oncologists or hematologists during that time, which accounted for 45% of the OOPCs. Patients spent an average of 6.8 ± 8.3 hours at MM-related monthly appointments, and 35.2% reported frustration while at the doctor's office. Patients with an MMAS-4 score of 4 reported higher FACT-MM scores (106.9 vs. 89.2; P <.001). Patients with an MMAS-4 score of ≤ 3 reported greater activity impairment (56.5% vs. 39.8%; P =.015) and feeling overwhelmed or frustrated with rescheduling MM appointments (64.0% vs. 26.0%; P =.002). Conclusion: MM was associated with significant workplace and functional impairment, high OOPCs, and frequent office visits. High medication adherence was associated with better outcomes across these domains. As survival for patients with MM improves, patient QoL should be considered to enhance these outcomes.

Original languageEnglish (US)
Pages (from-to)210-218
Number of pages9
JournalClinical Lymphoma, Myeloma and Leukemia
Issue number3
StatePublished - Mar 1 2018


  • Direct costs
  • Functional impairment
  • Health care resource usage
  • Quality of life
  • Work productivity impairment

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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