Adherence to treatment in patients with multiple myeloma and pain syndrome

Background. Treatment adherence is one of the key factors influencing the therapy outcome in patients with multiple myeloma complicated by pain syndrome.
Aim. To clarify the treatment adherence features in patients with multiple myeloma.
Materials and methods. The data of 61 patients with pain syndrome associated with bortezomib-induced polyneuropathy and oral mucositis were studied. Men – 17 (27.9 %), women – 44 (72.1 %). Median age – 52 (31–67) years. Assessment of pain syndrome and psychometric parameters of patients was performed in hospital before autologous hematopoietic stem cell transplantation (1st point), on the 8th (2nd point) and 100th (3rd point) days after transplantation. Validated algometric and psychometric methods were used.
Results. At each study point, patients with high adherence were grouped into 1st group, and patients with low adherence were grouped into 2nd group. At 1st point, statistically significant differences were noted between the groups in such indicators as quality of life / satisfaction and the degree of polyneuropathy. At the 2nd point, significant differences were found in the types of patient’s attitude toward illness: in the 1st group, adaptive types (harmonious, ergopathic) predominated, in the 2nd – maladaptive ones (anxious, neurasthenic, and sensitive). At 3rd point, a statistically significant difference was noted between the groups in the severity of mental disorders symptoms, the presence of which may be associated with decreased adherence to treatment, as well as the presence exclusively in the group with a low treatment adherence a maladaptive (egocentric) type of attitude toward illness.
Conclusion. Adherence to treatment in patients with multiple myeloma complicated by pain syndrome is a complex problem that requires a multidisciplinary team of specialists, which should include hematologists, algologists, and mental health specialists (psychiatrists, medical psychologists).