Health- Related Quality of Life for Multiple Myeloma Patients with Bone Metastases in Indonesia: A Cross-Sectional Study

Document Type : Research Articles


1 Doctoral Program, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.

2 Indonesian Herbal Medicine Department, Health Polytechnic of Surakarta, Ministry of Health Indonesia, Surakarta, Indonesia.

3 Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.


Objective: Multiple myeloma (MM) with bone metastases causes a skeletal-related event (SRE), and decreases
health-related quality of life (HRQoL). HRQoL needs to be evaluated for health technology assessment (HTA).
Furthermore, HRQoL is calculated as a health state utility and is used in the Markov Model for HTA. Therefore, this
study aimed to describe the HRQoL of MM patients with bone metastases, using The EuroQol five-dimension five levels
(EQ -5D-5L) in Indonesia. Methods: a cross-sectional, multicenter study for MM patients with bone metastases (aged
over 18 years old) that consulted a physician between November 2018 - May 2019 was conducted. The calculated
HRQoL illustrated the health state utility, which was assessed using the EQ-5D-5L questionnaire, with the Indonesian
value set. In addition, Mann-Whitney analyses were performed to determine the difference in utility scores at different
points within the Durie-Salmon staging system and skeletal condition. Results: in 93 patients who completed the
questioner, pain was their major concern with prevalence of over 60% (all levels inclusive). Moreover, the mean utility
of patients in stage II and III were 0.735 (SD = 0.205) and 0.383 (SD = 0.555), and those without SRE was 0.753 (SD
= 0.213) while patients with SRE was 0.302 (SD = 0.562). Therefore, the lessened values were observed at stage III
and SRE condition (p<0.05). Conclusion: MM patients with bone metastases have poor HRQoL, with pain as the
most frequently reported challenge, which is associated with an advanced stage of MM and SRE event.


Main Subjects