Older patients with multiple myeloma (MM) often rely on informal caregivers for transportation, information, and social support. Given the importance of these caregivers to patient outcomes, they form a patient-caregiver dyad that faces some shared challenges.
Researchers at the University of North Carolina at Chapel Hill sought the input of patient-caregiver dyads in understanding barriers to MM care. To do so, they recruited 21 patients with MM receiving treatment at the Lineberger Comprehensive Cancer Center, Chapel Hill, NC, and their informal caregivers for a total of 42 individuals. Each dyad participated in a semi-structured videoconference interview addressing topics such as barriers to care, quality of life (QOL), therapies, and function. Their responses were transcribed and synthesized.
The mean patient age was 70 and the mean caregiver age was 68. Almost all caregivers (90%) were intimate partners of the patients. Many (38%) had less than a college degree, and slightly fewer (37%) resided in “moderate or high social vulnerability communities,” according to the study.
The synthesized results showed 5 common barriers to health care access: accessibility and transport, cost, delayed diagnoses, delayed referrals, and difficulty scheduling clinic appointments. Some barriers affected certain dyads more than others.
“Residents of communities with high social vulnerability often reported accessibility and financial concerns,” the authors wrote. They noted that scheduling barriers also led to frustration compounded by limited knowledge about MM diagnosis and the subsequent referral process.
The report states that targeted efforts are needed to address the barriers in moderate and high social vulnerability communities, including “Multilevel interventions targeting individual, organizational, community, and policy.”
“In combination, these efforts could reduce the barriers that limit access to high-quality care for vulnerable populations,” concluded the report.