This retrospective cohort study used Taussig Cancer Center’s Myeloma Patient Registry to identify adults with multiple myeloma diagnosed between January 2017-December 2021. Electronic health records data captured time from diagnosis to initial prescription fill for oral antimyeloma medications and initiation of facility administered or oral antimyeloma treatment. We identified 720 patients with a mean age at diagnosis of 67 years ±11; 55% were male, 77% White, 22% Black, 1% other races, covered by private insurance (36%), traditional Medicare (29%), Medicare Advantage (25%), and Medicaid (8.3%). Over a third of patients (37%) resided in an area in the most disadvantaged area deprivation index (ADI) quartile. The median available follow-up was 765 days. Seventy-five percent of the cohort filled an oral antimyeloma medication prescription (excluding corticosteroids), with a median time to fill of 28 days (IQR, 15–61). In the multivariable Cox regression model, Black race (vs. White, adjusted hazard ratio [aHR], 0.61, 95% CI, 0.42–0.87), older age at diagnosis (aHR per 1 year, 0.97, 95% CI, 0.95–0.98), diagnosis during an inpatient admission (aHR, 0.63, 95% CI, 0.43–0.92), and estimated glomerular filtration rate ≤29 ml/min/1.73 m2 (vs. ≥60, aHR, 0.46, 95% CI, 0.29–0.73) were negatively associated with prescription fill for oral antimyeloma medication at 30 days, while insurance type and ADI were not significant predictors.
这项回顾性队列研究利用陶西格癌症中心多发性骨髓瘤患者登记系统，筛选出2017年1月至2021年12月期间确诊的成年多发性骨髓瘤患者。通过电子健康记录获取从确诊到首次领取口服抗骨髓瘤药物处方的时间数据，以及开始接受机构给药或口服抗骨髓瘤治疗的时间。共纳入720例患者，确诊时平均年龄为67岁±11岁；其中男性占55%，白人77%，黑人22%，其他种族1%；保险类型包括私人保险（36%）、传统医疗保险（29%）、优势医疗保险（25%）和医疗补助（8.3%）。超过三分之一患者（37%）居住于地区剥夺指数最不利的四分位区域。中位随访时间为765天。队列中75%的患者曾领取口服抗骨髓瘤药物处方（不含皮质类固醇），中位领取时间为28天（四分位距15-61天）。在多变量Cox回归模型中，黑人种族（相较于白人，校正后风险比[aHR] 0.61，95%置信区间0.42-0.87）、确诊时年龄较大（每增加1岁aHR 0.97，95%置信区间0.95-0.98）、住院期间确诊（aHR 0.63，95%置信区间0.43-0.92）以及估算肾小球滤过率≤29 ml/min/1.73 m²（相较于≥60，aHR 0.46，95%置信区间0.29-0.73）与30天内领取口服抗骨髓瘤药物处方呈负相关，而保险类型和地区剥夺指数未呈现显著预测作用。
Disparities in time to treatment with oral antimyeloma medications
肿瘤(癌症)患者之家