Authors: Tanya M. Wildes, MD, MSCI1, Nicholas C. Coombs, PhD, MSTAT2, Emily R. Beamon, PhD, MA, MPH2, Dasha Cherepanov, PhD3, Aaron Galaznik, MD4, Emelly Rusli, MPH4, Fjoralba Kristo, MD, MPH3
1University of Nebraska Medical Center/Nebraska Medicine, 2Piedmont Research Strategies, 3Takeda Pharmaceuticals, 4Carevive Systems Inc
- Social determinants of health (SDoH) are non-medical factors, such as income, education, employment, and area of residence, that can influence health outcomes.
- Research shows SDoH impact people’s health, wellbeing, and quality of life (QoL) and, for patients with cancer, treatment outcomes.1
- Electronic Patient Reported Outcomes (ePROs) integration into routine oncology practice improves patient time on therapy, survival, and resource utilization.2
- This study explores the use of an ePRO platform for routine gathering of SDoH incorporated into care for Multiple Myeloma (MM).
- Adult patients with MM undergoing treatment were enrolled in the Carevive remote symptom monitoring (RSM) platform between March 1, 2021 and April 20, 2023.
- Patients received baseline and weekly surveys to assess patient-reported symptom burden, physical function, overall health, and survey compliance. All surveys assigned at baseline and weekly were assessed in this study.
- Baseline characteristics included age, sex, race, frailty status (modified Geriatric Assessment, CARE survey item, and/or self-reported activity level), comorbidities, and SDoH (living-, caregiver-, marital-, employment-, education-, insurance-status, travel distance to cancer center).
- Symptoms (derived from the core and disease-specific PRO-CTCAE) and global health status/QoL (derived from the EORTC QLQ-C30, items #29 & #30) were assessed weekly, along with survey compliance.
- Results were stratified by SDoH status and compared by symptom burden and QoL.
- This study illustrates the feasibility of using RSM for gathering SDoH and patience experience indicators in routine clinical care.
- While overall survey compliance was high, 44% did not complete all SDoH items, indicating an opportunity for further exploration to enhance data ascertainment and reporting.
- Differences in symptom reporting rates indicate a potential need to focus on patients living alone, or without a caregiver.
- This further supports the importance and utility of SDoH indicators to identify actionable risk factors for poor health outcomes.
1 Venkataramany, B. S., & Sutton, J. M. (2022). Social Determinants of Health in Oncology: Towards a More Personalized and Equitable Delivery of Cancer Care. American journal of clinical oncology, 45(6), 273–278. https://doi.org/10.1097/COC.0000000000000914
2 Basch E, Deal AM, Kris MG, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: A randomized controlled trial. J Clin Oncol. 2016; 34: 557-65.