Depression Linked to Poor Adherence to Multiple Myeloma Treatment

A study from researchers at Sungkyunkwan University in Seoul, South Korea assessed how depression impacts treatment adherence among patients with multiple myeloma (MM).

“While continued lenalidomide and low-dose dexamethasone (Rd) treatment could improve survival outcomes for MM, the association of depression on the adherence to Rd regimen in [patients with MM] has never been studied even though depression is a common symptom among [patients with] MM,” wrote the authors. “This study aims to evaluate the impact of depression prior to Rd treatment on adherence to the treatment among patients with MM.”

The researchers enrolled 141 patients treated with Rd for MM between January 2015 and October 2018. Adherence was determined according to the number of completed treatment cycles, with poor adherence defined as fewer than four cycles, moderate adherence as 4–11 cycles, and good adherence as more than 12 cycles of treatment.

Overall, 41.8% of patients had depression prior to initiating treatment. The rate of good adherence was 46%, and 30.3% of these patients had depression at baseline. By contrast, 90.0% of patients who had poor adherence had depression before starting treatment. Patients with good adherence also reported lower levels of distress compared with patients in the poor adherence group (P<0.01).

After adjusting for age, sex, education level, and disease stage or status, the presence of depression prior to treatment initiation was significantly associated with poor adherence (incidence rate ratio 6.67; 95% confidence interval 1.45–30.61).

The authors wrote in conclusion, “Patients with depression had a substantially high risk of poor adherence compared to patients without depression. Given that Rd treatment is mainly offered by outpatient clinics, active interventions to reduce depression should be considered for [patients with MM] prior to Rd treatment.”

Findings from this study were published in Supportive Care in Cancer.