International Myeloma Foundation

Aims Therapeutic advancements have significantly improved patient outcomes in blood cancers. However, racial and ethnic disparities persist in treatment and access to care. Telehealth offers a promising solution to these disparities by using electronic and telecommunication technologies to deliver healthcare remotely. Ensuring access to telehealth depends not just on the technologies, but on the broader enabling environment, especially policy harmonization, communications infrastructure, and skills. This paper aims to advocate for the expanded use of telehealth in blood cancer management, highlighting its potential to improve equity and outcomes. Materials and methods An expert forum discussion results informed this systematic literature review which was performed to better understand the applied Telehealth solutions and the expected benefits. The forum discussion and the literature review findings were aggregated and reviewed by experts and patient advocates with personal experience in blood cancer. Results Our review of the literature yielded 18 relevant papers. Studies included patients from various disease areas; some studies used broader definitions of cancer to include more patients (i.e. acute leukemias and malignant lymphomas), while others were more specific to a particular condition. The identified Telehealth solutions were classified into two groups: solutions focusing on electronic consultation (n = 10) and solutions focusing on a specific intervention to improve patients’ health status (n = 8). A larger variety of outcomes were found in these studies, including quality of life, patient and clinicians’ acceptance, adherence, costs, and resource use. Conclusions Initial findings demonstrate that telehealth can potentially improve patient outcomes for people living with blood cancer, including improved patient quality of life, increased clinician acceptance, better adherence, and reduced costs and resource use to the health system. While evidence for virtual consultations show promising results, further research is needed due to the variety of study settings evaluated in this review. Providers and health systems need additional data on the positive economic impact of Telehealth related to the diagnostic journey and access to treatment.

BackgroundThe interrelation between the worldwide incidence, mortality, and survival of patients with multiple myeloma (MM) and relevant factors such as Health Care Access and Quality (HAQ) index, gross domestic product (GDP), health care expenditures, access to cancer drugs, and patient empowerment has not been addressed before.Material and MethodsEpidemiologic data were obtained from the International Agency for Research on Cancer. The mortality‐to‐incidence ratio (expressed as 1‐MIR) was used as proxy for 5‐year survival. Information on health expenditure was obtained from Bloomberg Health‐Care Efficacy ranking, the HAQ Index was used as a measure of available health care. For patient empowerment, visits to the Web site of the International Myeloma Foundation were used as proxy. Data on GDP and population per country were assessed from the International Monetary Fund and the United Nations Population Division, respectively. Possible associations were analyzed using Spearman's rank‐order correlation.ResultsThe worldwide incidence of MM is currently 160,000, and mortality is 106,000. Age‐standardized myeloma incidence varies between 0.54 and 5.3 per 100,000 and correlates with 1‐MIR, patient empowerment, HAQ Index, and access to cancer drugs. The 1‐MIR varies between 9% and 64% and is closely related to myeloma incidence, HAQ Index, patient empowerment, access to cancer drugs, and health care expenditures.ConclusionThe global incidence and outcome of MM shows significant disparities, indicating under‐recognition and suboptimal treatment in many parts of the globe. Results also highlight the importance of economic resources, access to and quality of health care, and patient education for improving diagnosis and survival of patients with MM.Implications for PracticeMultiple myeloma accounts for 10% of all hematological malignancies and has moved to the forefront of clinical interest because of the significant advances in medical treatment. Diagnosis depends on laboratory tests, imaging, and professional expertise, particularly in patients without a significant M‐component. The present data show a substantial worldwide variation in incidence and mortality, that is mainly due (apart from variations due to ethnicity and lifestyle) to disparities in access to and quality of health care, a parameter strongly related to the economic development of individual countries. Improvement of quality of care and, consequently, in outcome is associated with patient empowerment.