Prevalence of Physical Problems Detected by the Distress Thermometer and Problem List in Patients With Myeloproliferative Disorders

Abstract

Background Patients with myeloproliferative neoplasms (MPNs) can have severe physical symptom burden over an extended disease trajectory that contributes to decreased quality of life. Few studies, however, have characterized for which MPN patients physical symptoms are most frequently considered a problem. As such, this study describes MPN patients' physical symptoms and their relationship with patient characteristics. Methods Patients (N=117) with MPNs completed questionnaires in a dedicated academic medical center MPN clinic. Patients reported demographics (age, race/ethnicity, gender, marital status, employment status) and disease characteristics (MPN type, time with MPN). Patients reported whether they were bothered by any of 22 Physical Problem List variables from the Distress Thermometer and Problem List (DT&PL). Results The median number of physical problems endorsed by patients was 2 (M=2.26, SD=3.18) with a range from 0 to 20. Two-fifths endorsed no physical problems, one-fifth endorsed one problem, and two-fifths endorsed 2 or more problems. Fatigue (35.5%), sleep (27.1%), pain (21.5%), dry skin/pruritus (18.7%), and memory/concentration (16.8%) were the most commonly reported. Non-Caucasian participants reported more problems with sleep (p=.050), pain (p=.016), and tingling (p=.026). Polycythemia vera (PV) patients reported more issues with tingling (p=.046) and sexual problems (p=.032). Conclusion It is more likely among patients with MPN to report physical symptom bother than to report no bother with multiple physical problems on the DT&PL. Patients of minority race/ethnicity and those with PV, however, showed heightened prevalence of physical problems, characteristics which may be used to triage patients for more intensive symptom management.

Associations of Physical and Psychologic Symptom Burden in Patients With Philadelphia Chromosome-Negative Myeloproliferative Neoplasms

“…Details for the current study have been previously reported and are reviewed in brief here. 17 The Mount Sinai Hospital Institutional Review Board approved this study and all participants provided informed consent prior to participation. Data were collected from May 2015 to October 2015.…”

“…The effect of psychosocial distress variables on total number of items endorsed from the PPL was tested using negative binomial regression, as the outcome variable (total PPL items) represents a count variable, which was over-dispersed (i.e., Pearson’s chi square value for the model using Poisson regression χ 2 /df = 1.61). 22 Demographic and disease-related factors that were found to be significantly related to endorsement of specific physical problems in our prior work 23 were included as covariates. Statistical procedures were performed using the SPSS version 24 software (SPSS, Chicago, IL 2013) and statistical tests were two-tailed with a 5% significance level.…”

The Critical Role of Inflammation in the Pathogenesis and Progression of Myeloid Malignancies

“…The impact that physical symptoms have on quality of life and general well being in patients with hematologic malignancies is under-recognized, as most therapies are focused on blood counts rather than symptoms. Recent studies have revealed how much the physical symptom burden weighs on the psychology of patients with hematologic disorders [ 32 ], and how this diagnosis can lead to distress, depression, and anxiety [ 33 ] . In aggressive hematologic malignancies such as AML, the major focus is on eradication of the leukemic clone because the consequence of not targeting the mutant clone is fatal.…”