Completion of Distress Screening and Correlates of Distress Score in Patients With Multiple Myeloma at Initial Evaluation at a Transplant Center

Objectives

We describe the completion of the National Comprehensive Care Network's distress thermometer (DT) survey for multiple myeloma (MM), quantify, and identify factors influencing distress score.

Methods

We assessed DT completion for MM patients' first consultation at an academic center between January 1, 2015, and December 31, 2022. Multivariate logistic regression was conducted to identify factors associated with survey completion and distress.

Results

Of 1011 new patients, 683 (68%) completed the DT survey. Noncompletion at initial consultation was associated with non-Hispanic Black patients [AOR 0.50 (95% CI 0.32–0.79), p = 0.003], socially vulnerable neighborhood residence [AOR 0.54 (95% CI 0.39–0.76), p = 0.0004], Karnofsky Performance Status < 90 [AOR 0.60 (95% CI 0.43–0.86), p = 0.005], and recent years of consult [AOR 0.38, (95% CI 0.28–0.52), p < 0.0001]. Nonrespondents were less likely to receive a subsequent autologous stem cell transplantation (71% vs. 79%, p < 0.01). The median distress score among respondents was 3% with 22% reporting 0 distress. Distress was associated with female sex [AOR 1.48, (95% CI 1.07–2.04), p = 0.017] and stage [stage 2 vs. stage 1, AOR 1.76 (95% CI 1.20–2.57), p = 0.004].

Conclusions

Disparities in nonrespondents of the DT survey at initial consultation suggest the limitations of relying on the screening tool to assess unmet needs among high-risk patients.