Understanding the Role of Social Determinants of Health in Multiple Myeloma Care With Catherine Forbes, PharmD

Catherine Forbes, PharmD, a Clinical Pharmacy Specialist at Roswell Park Comprehensive Cancer Center, recently coauthored an abstract presented at the American Society of Hematology (ASH) Annual Meeting regarding how social determinants of health (SDOH) impact survival outcomes in patients with multiple myeloma. Her research highlights the profound influence of socioeconomic factors on disease progression and patient survival.

Key Findings: Disparities in Survival Outcomes

Dr. Forbes and her team conducted a retrospective analysis spanning a decade, examining patients treated since 2013. Using the US Census data and the Area Deprivation Index (ADI) developed by the University of Wisconsin, they analyzed factors such as income, education, housing conditions, and access to transportation. These metrics enabled the team to assess patients’ socioeconomic status (SES) at a granular level, even within specific neighborhoods.

The findings revealed stark disparities in survival outcomes. Patients from disadvantaged backgrounds, as measured by higher ADI scores, exhibited significantly lower progression-free and overall survival rates compared to their less disadvantaged counterparts. The results were consistent across different patient subgroups, including those who underwent transplants—a common treatment for multiple myeloma. Interestingly, high-income patients with high-risk cytogenetics often outperformed low-income patients with standard-risk profiles, underscoring the outsized impact of SES on health outcomes.

The Area Deprivation Index: A Tool for Assessing Disadvantage

The ADI serves as a vital tool in evaluating social determinants by incorporating metrics such as education, employment, and living conditions. It provides neighborhood-level insights into the challenges patients face, enabling researchers and clinicians to better understand and address socioeconomic barriers.

Integrating Social Determinants of Health into Clinical Practice

Addressing these disparities, Dr. Forbes emphasized the importance of screening and intervention within clinical practice. At Roswell Park, every patient undergoes a thorough assessment through standardized questionnaires addressing domains such as food security, housing stability, and access to care. When risks are identified, multidisciplinary teams, including social workers, pastoral care providers, and specialized pharmacists, offer tailored support. These proactive measures aim to mitigate the negative effects of SDOH on treatment outcomes.

Looking Ahead: Expanding Research and Interventions

Dr. Forbes advocates for ongoing research and intervention strategies. She expressed a desire to expand the study to include more recent data, tracking progress over the last decade to assess whether interventions have improved outcomes. This longitudinal approach could provide invaluable insights into how healthcare systems can evolve to better address SDOH-related disparities.

Empowering Patients to Advocate for Their Needs

From a patient perspective, Dr. Forbes highlighted the importance of open communication with care teams. Patients are encouraged to discuss challenges such as transportation issues, financial concerns, or difficulties accessing nutritious food. Transparency in completing screening tools can help care teams connect patients with available resources, ensuring more holistic support throughout their treatment journey.

A Call to Action for Health Equity in Oncology

This research highlights the essential role of SDOH in shaping multiple myeloma outcomes and the urgent need for targeted interventions. Dr. Forbes’ work serves as a call to action for healthcare professionals to address these factors systematically, paving the way for more equitable cancer care.

About Dr. Forbes

Catherine Forbes, PharmD, is a Clinical Pharmacy Specialist at Roswell Park Comprehensive Cancer Center. She serves on the Multiple Myeloma Care Team, on which she and other pharmacists review each patient’s pharmaceutical treatment for potentially harmful interactions and educate patients about their therapy and options to prevent side effects.