Document Type : Research Articles
Doctoral Program, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
Indonesian Herbal Medicine Department, Health Polytechnic of Surakarta, Ministry of Health Indonesia, Surakarta, Indonesia.
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.