Authors
Nikitina T.P.1, Melnichenko V.Ya.2, Fedorenko D.A.2, Sarzhevskiy V.O.2, Porfirieva N.M.3, Ionova T.I.1
1 Saint Petersburg State University Hospital, Saint Petersburg
2 Pirogov National Medical and Surgical Center, Moscow
3 Multinational Center for Quality of Life Research, Saint Petersburg
Abstract
Rationale: during auto-HSCT, it is of great importance to monitor the patient’s condition after discharge for control of side effects, correction of accompanying therapy and assessing the patient’s recovery.
Objective: to study the dynamics of quality of life (QoL) and symptoms in patients with hematological malignancies after auto-HSCT using the electronic HESA system (Health – Electronic Self-Assessment).
Methods: The data were analyzed in patients with hematological malignancies who underwent auto-HSCT from March 2023 to November 2024. Patients filled out questionnaires based on HESA before auto-HSCT and at discharge, as well as remotely at different times after discharge. HESA is a secure web platform based on standardized HM-PRO and HADS questionnaires. Data obtained using HESA were used to analyze the dynamics of QoL by HM-PRO and dynamics of anxiety/depression by HADS and to identify significant changes in QoL and psychological health at different times after discharge.
Results: the data were obtained on 119 patients (male/female 55/64) aged from 19 years to 72 years (mean age 43 years); 48% patients had Hodgkin lymphoma (HL), 21% – non-Hodgkin lymphoma (NL) and 31% – multiple myeloma (MM). Prior to auto-HSCT, 56% of patients had significantly impairment of emotional functioning, 42% – physical functioning, 20% – social functioning, and 40% had significant problems due to impaired eating and drinking habits. In 40% of patients, symptoms had a significant impact on their condition. Most often, patients experienced severe fatigue (69%), insufficient energy (65%) and hair loss (43%). 14% and 10% of patients had borderline/elevated levels of anxiety/depression. After discharge, 38% of patients completed HESA remotely (maximum duration of monitoring – 22 months, median – 11 months). During monitoring, a part of patients recorded a deterioration in certain indicators: 38% – in terms of QoL impairment, 18% – in terms of symptom effect; 18% and 27% have an increase in anxiety and depression, respectively. At the end of the follow-up 29% patients had significant negative dynamics in QoL, 16% – significant increase in the symptoms effect. In 16% and 24%, respectively, the increasing of anxiety and depression was revealed. The treating physicians used information, obtained with HESA for interaction with patients to optimize the accompanying therapy.
Conclusion: the use of HESA in patients with hematological malignancies undergoing auto-HSCT should be used for timely interaction with the patient and can contribute to the implementation of patient-oriented care.
Keywords: autologous hematopoietic stem cell transplantation, hematological malignancies, quality of life, symptoms, electronic system, daily clinical practice.
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