The Cancer Supportive Care Model

A Patient-Partnered Paradigm Shift in Health Care Delivery

Elias Anaissie, MD; Tara Mink, RN


J Participat Med. 2011;3 

In This Article

Multiple Myeloma

Multiple myeloma (MM) is a disease primarily affecting the older population with a median age of 62-73 years, with 15,000 new cases per year in the US alone.[9] Major treatment advances in MM have occurred over the past two decades, including the introduction of novel agents and application of high-dose chemotherapy (HD) followed by autologous hematopoietic stem cell transplantation (ASCT).[9] Typically, HD-ASCT causes profound suppression of hematopoiesis leading to increased risk for infection and is usually performed in the hospital setting until hematopoietic recovery (approximately 21 days).[10] Despite these treatment advances, patients with MM receiving therapy suffer various complications as a result of the interaction between three factors: 1) The disease, which increases the risk for infection, renal failure, symptomatic anemia and fractures causing severe pain and decreased mobility;[10] 2) the treatment given to reverse these complications and extend survival but which may cause severe diarrhea, nausea, vomiting, infections and other complications; and 3) the older age of this population which puts them at risk for hospital-related complications such as infections, muscle wasting, malnutrition, depression, a sense of isolation, frailty, delirium, and others.[10 11]

Disempowerment and Loss of Dignity

Patients with a life-threatening condition such as MM experience a loss of control over their lives. This feeling is compounded by confinement in a hospital, where staff shortages and cost-cutting measures may interfere with a timely response to their basic needs such as calls for toileting, pain control, and others. These unmet needs leave patients with a feeling of loss of dignity.

The Myeloma Institute for Research and Therapy (MIRT)

MIRT was established by Dr. Bart Barlogie, a world-renowned expert in MM with the goal of improving patient survival, at the University of Arkansas for Medical Sciences (UAMS) in Little Rock, Arkansas. The MIRT Supportive Care Program was developed to further improve outcomes by fostering active patient participation in the treatment process, including the prevention of prolonged hospitalization and hospital-associated complications.


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