{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:06:34Z","timestamp":1777917994367,"version":"3.51.4"},"reference-count":58,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"St Christopher\u2019s Hospice, London"},{"DOI":"10.13039\/501100004636","name":"Myeloma UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with multiple myeloma, an incurable haematological cancer, often receive palliative care only late in their trajectory. Criteria for early referral are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To identify which patients might benefit from early integration, by identifying trajectories of health-related quality of life and the determinants for declining or poor Health related quality of life .<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Prospective, longitudinal cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Multiple myeloma patients at all stages (newly diagnosed, first-line or second-line treatment, early or later treatment-free interval, refractory disease) from in- and outpatient units at 14 hospitals in England were recruited. In addition to clinical information and standardised Health related quality of life and psychological aspects, the Myeloma Patient Outcome Scale (MyPOS) measured palliative care concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 238 patients were recruited, on average 3.5\u2009years ( SD: 3.4) post-diagnosis. Latent mixture growth models identified four Health related quality of life trajectories. Classes 3 and 4 represent trajectories of stable poor Health related quality of life or declining Health related quality of life over an 8-month period. The strongest predictors of poor outcome at the end of follow-up were general symptom level (odds ratio (OR): 1.3, 95% CI: 1.0\u20131.6, p\u2009=\u20090.028), presence of clinically relevant anxiety (OR: 1.2, 95% confidence interval (CI): 1.0\u20131.4, p\u2009=\u20090.019), and presence of pain (OR: 1.02, 95% CI: 1.0\u20131.1, p\u2009=\u20090.018), all being more predictive than demographic or clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>General symptom level, pain and presence of anxiety predict declining Health related quality of life in multiple myeloma. Identification of patients with palliative care needs should focus on assessing patient-reported symptoms and psychosocial well-being for identifying those at risk of deterioration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0269216319833588","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T14:58:02Z","timestamp":1557241082000},"page":"541-551","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":41,"title":["Symptoms and anxiety predict declining health-related quality of life in multiple myeloma: A prospective, multi-centre longitudinal study"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9996-1818","authenticated-orcid":false,"given":"Christina","family":"Ramsenthaler","sequence":"first","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King\u2019s College London, London, UK"},{"name":"Department of Palliative Medicine, University Hospital Munich, Munich, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Gao","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J","family":"Siegert","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King\u2019s College London, London, UK"},{"name":"Department of Psychology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Polly M","family":"Edmonds","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen A","family":"Schey","sequence":"additional","affiliation":[{"name":"Department of Haematological Medicine, King\u2019s College Hospital NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene J","family":"Higginson","sequence":"additional","affiliation":[{"name":"Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,5,7]]},"reference":[{"key":"bibr1-0269216319833588","unstructured":"World Palliative Care Alliance. \u2018Global atlas of palliative care at the end of life\u2019, 2014, http:\/\/www.who.int\/cancer\/publications\/palliative-care-atlas\/en\/"},{"key":"bibr2-0269216319833588","volume-title":"Implementing cancer survivorship care planning \u2013 workshop summary","author":"Institute of Medicine National Cancer Policy Forum","year":"2007"},{"key":"bibr3-0269216319833588","volume-title":"The national cancer survivorship initiative vision","author":"Department of Health","year":"2010"},{"key":"bibr4-0269216319833588","volume-title":"Improving outcomes in haematological Cancers \u2013 the manual","author":"National Institute for Clinical Excellence (NICE)","year":"2003"},{"key":"bibr5-0269216319833588","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.05207.x"},{"key":"bibr6-0269216319833588","unstructured":"Haematological Malignancy Network; Epidemiology & Cancer Statistics Group. \u2018Statistics \u2013 individual disorders. 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