The Impact of Multiple Myeloma on Care Partner Well-Being, Work Productivity, and Resource Use in the United States and Western Europe

BACKGROUND

The impact of multiple myeloma (MM) extends beyond the affected patients themselves as care partners and family members also experience significant negative effects on their own quality of life (QOL), psychological well-being, and productivity. The objective of this study was to quantify the extent of this burden among care partners in both the United States (US) and Europe.

METHODS

This study analyzed data from the 2021 and 2022 National Health and Wellness Survey (NHWS) conducted in the US and European Union 4 (EU4; France, Germany, Italy, Spain) + United Kingdom (UK; ie, EU4+UK). The NHWS is a cross-sectional, population-based health survey administered online to a demographically representative sample of adults in each country (N=75,261 in the US; N=15,013 in France; N=15,009 in Germany; N=10,001 in Italy; N=7,003 in Spain; and N=15,002 in the UK). Survey questions assessed demographics, health history, and health outcomes of all respondents. Additionally, all respondents were asked whether they are currently providing care to an adult relative with a set list of conditions, including MM. Separately for each region (US and EU4+UK), individuals reporting that they provide care to a family member with MM (care partner cohort) were compared 1:1 to country-, age-, sex-, and comorbidity-matched controls (matched control cohort) on health status (RAND-36 [in the US] / Short Form [SF]-12v2 [in the EU4+UK]), QOL (EuroQoL-5 Dimensions [EQ-5D]), work productivity and activity impairment (Work Productivity and Activity Impairment – General Health [WPAI-GH] questionnaire), self-reported healthcare resource use, and psychosocial burden, which included self-reported anxiety, depression severity (Patient Health Questionnaire-9 [PHQ-9]), and self-reported sleep difficulties/insomnia. Analyses included t-tests for means and chi-square tests for proportions.

RESULTS

N=105 individuals in the US reported providing care for a patient with MM (mean age = 39.1 years, 58.1% male, 61.0% non-Hispanic White; 57.1% had a university degree). The patient with MM that was being cared for was typically either a parent (31.4%) or spouse/partner (28.6%) and the majority (81.9%) were in active treatment. Similar data was reported among individuals in the EU4+UK (N=70 care partners with a mean age of 36.9 years, 65.7% male, and 32.9% had a university degree; 35.7% and 37.1% were either a child of, or spouse/partner to, the patient with MM; 74.3% of patients were in active treatment). Compared with matched controls, both US and EU4+UK care partners experienced statistically significantly (all p<.05) lower mean levels of overall mental health status (35.7 vs 43.2 and 41.5 vs 46.4 in the US and EU4+UK, respectively), lower overall physical health status (35.4 vs 46.1 and 43.3 vs 49.9), lower QOL based on the EQ-5D index (0.63 vs 0.81 and 0.57 vs 0.82), higher mean levels of overall work impairment among those full-time employed (N=71 and 46 care partners and controls in the US, respectively, were currently full-time employed; N=33 and 31, respectively, in the EU4+UK) (82.3% vs 25.0% and 71.9% vs 29.9% of total work time was impaired), more physician visits in the past 6 months (7.7 vs 3.7 and 9.6 vs 3.6), more emergency room visits (2.8 vs 0.3 and 4.0 vs 0.2), and more hospitalizations (3.0 vs 0.2 and 2.3 vs 0.3). Rates of anxiety (62.9% vs 38.1% and 62.9% vs 34.3%), mild to severe depression (87.6% vs. 41.9% and 80.0% vs 50.0%), and sleep difficulties (58.1% vs. 49.5% and 65.7% vs 40.0%) were also all significantly higher among care partners than matched controls across both regions.

CONCLUSIONS

Adding to the significant toll that MM places on society, care partners for patients with MM can experience a significant burden on their own wellbeing, including increased rates of anxiety, depression, and sleep difficulties, resulting in worse QOL. Further, they experienced significant impairments in their ability to work productively and reported increased rates of healthcare resource utilization.