A large, nationwide study of people with multiple myeloma found that those receiving home health services were more likely to suffer from more chronic conditions and had higher early mortality rates. This indicates a need for better disease management and supportive care at home.
The researchers used the Outcome and Assessment Information Set to produce a sample of more than 37,000 people with multiple myeloma, of which nearly 7,000 were recipients of home healthcare.
Home health patients with multiple myeloma were found more likely to be older, and roughly 45% were 82 years or older, according to the study. They were also more likely to be female, Black and unmarried, and live in a county with a higher level of poverty.
Multiple myeloma patients’ degree of disability — graded as “mild, moderate or severe” — was split roughly in thirds, with the largest share experiencing mild multiple myeloma.
The vast majority of home health patients with multiple myeloma suffered from additional chronic conditions. About 3 in 4 fee-for-service Medicare beneficiaries in home healthcare had two or more comorbidities. Meanwhile, those patients with multiple myeloma but not in home health were more than twice as likely to have no comorbidities, and about 68% more likely to only have one comorbidity.
And while home-based care has often been hailed as a way to prevent early mortality, those home care patients with multiple myeloma sampled in the study had a 55% higher three-year mortality rate, especially among those with moderate and severe disability status. Patients with multiple myeloma and severe disability status were about 30% less likely to receive home treatment for multiple myeloma, but those with a moderate disability level were about 10% more likely to be treated.
The results indicated a pressing need for home health providers to find ways to better treat those patients that suffer from chronic conditions like multiple myeloma, according to the researchers.
“Among older adults with [multiple myeloma] receiving [home health] services, disability is a predictor of early mortality,” they said. “[Home health] service receipt may also identify individuals who would most benefit from more thorough clinical assessments, such as geriatric assessment, to identify other areas of vulnerability and opportunities for management and supportive care.”