The National Institute on Aging has awarded Shakira Grant, MBBS, and the UNC Center for Aging and Health a 2-year, $200,000 grant to study the illness and treatment experiences and functional trajectories of older adults with multiple myeloma and their care partners.
Multiple myeloma is a disease of aging, with a median age at diagnosis of almost 70 years. It is also a disease of relevance to Black Americans who are twice as likely to be diagnosed with multiple myeloma and to die from the disease. Most adults with this condition also have several other age-related health conditions, including multiple chronic diseases, cognitive and functional limitations. Furthermore, quality-of-life for patients with multiple myeloma is much lower than for those with other blood cancers. In this respect, the needs of older adults with multiple myeloma differ in important ways from those of other cancer populations. With the increasing availability of new therapies to treat myeloma, there is a growing urgency to understand how the benefits and harms of these treatments shape functional capacity, quality-of-life, and the illness experience. For older Black adults the need is more urgent to reduce the disparate survival outcomes for this population.
Prior studies have failed to account for baseline (pretreatment) level of functioning and have generally focused on traditional disease-centric metrics such as survival and remission status and have not incorporated the range of outcomes that might be important to patients. While disease-specific endpoints remain highly relevant to older adults with myeloma, more global outcome measures addressing the impact of disease and treatment on the whole person are critical. Therefore evaluating measures of function and quality-of-life which are increasingly relevant to older adults is critical as these can profoundly shape the illness experience.
Furthermore, this mixed-methods study will also use interviews with patients and care partners to obtain a comprehensive perspective on the true impact of multiple myeloma and its treatments on the outcomes of this population.
For this transdisciplinary study, Shakira Grant, MBBS, will work with collaborators and mentors in the Odum Institute for Research in Social Science, the Center for Aging and Health, and the Lineberger Comprehensive Cancer Center.
Knowledge gained from this pilot observational study will inform the design of additional studies to develop and test interventions to support shared decision-making and a more individualized, person-centered approach to care for older adults with multiple myeloma. Overall by understanding the experiences of older adults, in particular those who self-identify as Black along with the perspectives of their care partners, we hope to unearth and ultimately address those factors that continue to drive disparate outcomes among this subgroup of patients with multiple myeloma.