Assessment of Bone Health Education in US Multiple Myeloma and Solid Tumor Patients at Risk for Skeletal-Related Events

Abstract

Purpose: Cancer patients with bone metastasis (BM) from solid tumors or multiple myeloma (MM) have an increased risk of painful skeletal-related events (SREs), which can decrease quality of life and increase mortality. Bone targeting agents (BTAs) can help delay or prevent SREs; however, a significant portion of eligible patients are not receiving BTA therapy. This study was conducted to understand patient awareness of cancer-related bone health and to identify opportunities to improve bone health education in cancer patients at risk of SREs. Methods: The online BonE heAlth eduCatiOn Needs assessment (BEACON) survey included questions about patient demographics, cancer diagnosis and treatments (including BTA usage), and extent and satisfaction with bone health education received. Direct-topatient outreach was used to recruit patients. Eligible patients were US adults with a diagnosis of self-reported MM or BM from a solid tumor (breast, lung, or prostate cancer) within the past three years. Results: Of 125 patients, 71% were diagnosed with solid tumors with BM and 29% with MM. At least one prior SRE was experienced by 57% of patients (38% radiation to bone, 32% bone fracture, 22% spinal cord compression, and 19% surgery to bone), and 74% were currently receiving BTA therapy. Awareness of cancer bone health, protection strategies, and screening tests was low to moderate; patients were least informed of the impact of lifestyle changes (38%) and specific cancer treatments (≤35%) on bone health. Sixty-two percent of patients were not completely satisfied with the bone health education received. Patients generally wanted more information (58%) and to receive information by more than one mode of communication. Conclusion:Notable gaps in bone health education were observed in cancer patients at risk for SREs indicating an important need for improved communication and education strategies to promote better health outcomes.

Assessment of Bone Health Awareness and Education in Breast Cancer Patients with Bone Metastasis in the USA

“…More than 75% of patients were aware of pharmacologic interventions such as calcium and/or vitamin D supplements and BTAs as a preventative strategy for bone health; however, awareness of regular exercise and lifestyle changes as preventative strategies was lacking. Awareness responses were comparable to previous observations in a mixed cancer patient cohort at risk for SREs [ 26 ]. Approximately 70% of patients responded via an open response on what they wished they had been told about the health of their bones; many still had unanswered questions.…”

“…The BEACON survey contained questions about patient demographics; timing of diagnosis; cancer treatments received; experience with cancer-related SREs; current use of a BTA; awareness of general cancer-related bone health, bone health protection, and screening for bone health; and bone health education received (source(s), mode(s), amount, and level of satisfaction). Detailed information about the study design and survey content was previously published [ 26 ]. The study was approved by Western Institutional Review Board and conducted in accordance with the Declaration of Helsinki.…”

“…GRYT Health managed all patient interactions. Study data included 74 BC patients with BM from the initial BEACON survey study population [ 26 ]. All data reported is based on patient response; medical records were not requested or reviewed.…”

“…Most cancer-related bone health studies utilize electronic health record databases and physician opinions to understand real-world treatment of cancer patients at elevated risk for SREs, with few studies leveraging the insights directly from patients [ 15 , 24 – 26 ]. Leveraging a unique direct-to-patient recruitment approach, we previously conducted the BonE heAlth eduCatiOn Needs assessment (BEACON) survey among patients with multiple myeloma or BM secondary to solid tumors to understand sources, types, and extent of bone health education, and to identify opportunities to improve cancer-related bone health education to enhance appropriate BTA use and health outcomes [ 26 ]. In this study, we exclusively expanded recruitment of BC patients with BM to focus on bone health education practices and knowledge.…”

Medication adherence with denosumab in patients with bone metastases from solid tumors treated in routine clinical settings: a retrospective study

“…Despite adherence with denosumab being generally high across the initiation, implementation, and persistence phases, there is scope for adherence to be improved. Some potential strategies are summarized in Table 3 [35][36][37][38]. Strategies to improve medication adherence may reduce avoidable hospitalizations and improve patient quality of life, with resulting cost savings [39,40].…”