{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:24:37Z","timestamp":1763058277937,"version":"build-2065373602"},"reference-count":51,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T00:00:00Z","timestamp":1564963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR001862"],"award-info":[{"award-number":["KL2 TR001862"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,11,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>With improving survival for patients with multiple myeloma (MM), supportive care that is focused on optimizing quality of life and minimizing treatment\u2010related toxicities is increasingly important. The extent to which patients with MM are receiving recommended supportive care is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used the Surveillance, Epidemiology, and End Results\u2013Medicare database to identify older adults (age\u00a0\u226566\u00a0years) diagnosed with MM in 2008\u20102013 who had received active treatment and survived 1\u00a0year or longer after their diagnosis. Outcomes of interest included guideline\u2010recommended supportive care, which was defined as 1) bone\u2010modifying drugs (BMDs) within the 12\u00a0months after the diagnosis, 2) influenza vaccination in the first season after the diagnosis, and 3) concomitant use of prophylactic antivirals with proteasome inhibitors. Multivariable logistic regression models were used to evaluate associations between patient\/facility\u2010level characteristics and supportive care use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1996 patients receiving MM\u2010directed therapy, 64%, 52%, and 49% received BMDs, an influenza vaccination, and antiviral prophylaxis, respectively. Non\u2010Hispanic black patients (odds ratio [OR] vs white patients, 0.63; 95% confidence interval [CI], 0.46\u20100.88) and patients with baseline renal impairment (OR, 0.43; 95% CI, 0.34\u20100.54) had lower odds of BMDs. Non\u2010Hispanic blacks (OR, 0.52; 95% CI, 0.37\u20100.73) and those with dual Medicaid enrollment (OR, 0.76; 95% CI, 0.58\u20100.99) had lower odds of influenza vaccination. Treatment in a community\u2010based setting was associated with reduced odds of antiviral prophylaxis (OR, 0.58; 95% CI, 0.46\u20100.72).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Substantial underutilization of guideline\u2010recommended supportive care was observed among older adults with MM in the United States, and this was associated with both patient and facility characteristics. Targeted interventions are needed to improve supportive care for patients with MM.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.32428","type":"journal-article","created":{"date-parts":[[2019,8,5]],"date-time":"2019-08-05T07:53:28Z","timestamp":1564991608000},"page":"4084-4095","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Underutilization of guideline\u2010recommended supportive care among older adults with multiple myeloma in the United States"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1827-5032","authenticated-orcid":false,"given":"Smith","family":"Giri","sequence":"first","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiwei","family":"Zhu","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2169-4174","authenticated-orcid":false,"given":"Rong","family":"Wang","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"},{"name":"Department of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amer","family":"Zeidan","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolai","family":"Podoltsev","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven D.","family":"Gore","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Neparidze","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomei","family":"Ma","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"},{"name":"Department of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4974-935X","authenticated-orcid":false,"given":"Cary P.","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut"},{"name":"Department of Internal Medicine Yale School of Medicine New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8141-9249","authenticated-orcid":false,"given":"Amy J.","family":"Davidoff","sequence":"additional","affiliation":[{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"},{"name":"Department of Health Policy and Management Yale School of Public Health New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7071-6475","authenticated-orcid":false,"given":"Scott F.","family":"Huntington","sequence":"additional","affiliation":[{"name":"Section of Hematology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut"},{"name":"Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center New Haven Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,8,5]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"National Cancer Institute.Cancer Stat Facts: Myeloma.https:\/\/seer.cancer.gov\/statfacts\/html\/mulmy.html. 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