Introduction: Malignant haematological diseases (MHDs) are increasingly the focus of research interest due to their rising global disease burden and the continuous need for improved management strategies. The dynamic evolution of therapeutic protocols has significantly enhanced survival rates for patients with MHDs. However, many of these patients often experience deteriorated overall health, emphasizing the importance of addressing health-related quality of life (HrQoL).
Aim: This study aims to conduct a comparative analysis of the perspectives of MHD patients and hematologists regarding the nature and role of subjective assessment or HrQoL in routine clinical practice.
Materials and Methods: The study, designed as a pilot initiative, explores the need and feasibility of larger-scale research within patient and haematologist communities. The research protocol targeted two groups of participants: a maximum of 100 MHD patients treated at the Clinical Haematology Clinic of St. Marina University Hospital in Varna between March and April 2024, and all 12 haematologists in the clinic. Inclusion criteria for patients were a confirmed MHD diagnosis, signed informed consent, and age of at least 18 years.
The research was preceded by a literature review in PubMed and Google Scholar (as of April 2024) using key terms in Bulgarian and English: "health-related quality of life" and "malignant haematological diseases." Based on the literature, the team's experience, and the study’s objectives, two survey instruments were developed – one for MHD patients and one for medical professionals. A descriptive statistical approach was employed to analyse the collected data. Ethical approval for the protocol was obtained.
Results: The study found that medical professionals prioritize therapeutic outcomes over HrQoL, though they acknowledge the need for routine HrQoL assessments. Patients, however, value not only clinical improvement but also the preservation or enhancement of HRQoL. Both groups agreed on the need for psychological support to improve HrQoL, including in clinical settings.
Conclusion: Assessing HrQoL in MHD patients holds substantial social and personal importance, warranting its dedicated place in chronic disease management. Despite significant clinical and administrative workloads, medical professionals exhibit positive attitudes toward subjective health evaluations. Addressing these critical areas in routine care for MHD patients points to future research directions that could foster the development of effective practices and updated recommendations to support patients.
WHO Regional Office for Europe et al., Chronic Diseases: Global Burden and Prevention Strategies. World Health Organization. 2010.
Centers for Disease Control and Prevention (CDC). About Chronic Diseases. 2024.
https://www.cdc.gov/chronicdisease/about/index.htm, accessed 11.2024.
Zhang Y., et al. The Global Burden of Hematologic Malignancies: An Epidemiological Analysis from 1990 to 2019. The Lancet Hematology, 2023. 10(2), 122-135.
Murray CJL. The Global Burden of Disease Study at 30 years. Nat Med. 2022 Oct;28(10):2019-2026. doi: 10.1038/s41591-022-01990-1. Epub 2022 Oct 10. PMID: 36216939.
GLOBOCAN, The WHO Global Cancer Observatory, https://gco.iarc.fr/en, accessed 11. 2024
The Cancer Today database by GLOBOCAN,
https://gco.iarc.fr/today/en/dataviz/pie?mode=population&group_populations=0, accessed 11. 2024
Yang L., Chen J., Ting Sun, et al., Global Burden and Disparities in Hematologic Malignancies: A Comparative Analysis from 1990 to 2019, Blood, V. 142, Issue Supplement 1, November 2 2023.
Mafra A, Laversanne M, Marcos-Gragera R, Chaves HVS, Mcshane C, Bray F, Znaor A. The global multiple myeloma incidence and mortality burden in 2022 and predictions for 2045. J Natl Cancer Inst., 2024, doi: 10.1093/jnci/djae321. Online ahead of print.
Bulgaria in 2022, GLOBOCAN,
https://gco.iarc.who.int/media/globocan/factsheets/populations/100-bulgaria-fact-sheet.pdf , accessed 11.2024.
Ванкова Д. Щастие, качество на живот и здраве, Издателски център на медицински университет – Варна, 2023. ISBN 978-619-221-451-7, стр. 9.
Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Engl J Med. 1996;334 (13):835–840.
Allart-Vorelli P, Porro B, Baguet F, Michel A, Cousson-Gélie F. Haematological cancer and quality of life: a systematic literature review. Blood Cancer J. 2015 Apr 24;5(4):e305. doi: 10.1038/bcj.2015.29. PMID: 25909835; PMCID: PMC4450328.
Pamuk, G.E., Health-Related Quality of Life in Hematological Malignancy Patients in Northwestern Turkey, Blood, 2012, 120 (21) : 4709.
Konstantinidis, T.I.; Tsatsou, I.; Tsagkaraki, E.; Chasouraki, E.; Saridi, M.; Adamakidou, T.; Govina, O. Quality of Life and Symptoms of Hospitalized Hematological Cancer Patients. Curr. Oncol. 2024, 31, 6699–6710. https://doi.org/10.3390/curroncol31110494
Lee S et al., Physicians’ attitudes about quality-of-life issues in hematopoietic stem cell transplantation, Blood, 1 October 2004, V. 104, 7, 2194-2200.
Ванкова Д., Качество на живот, свързано със здравето, Социална медицина, 2010, стр. 6-9.
Левтерова Б., Самооценката за здравен статус като резултативен показател за здравни грижи, Управление и образование, tom 15 (5) 2019. Бургас, стр. 32-34.
Насева Е. и кол., Качество на живот, свързано със здравето при пациенти над 60 и повече навършени години в областите Ямбол и София-град, Здравна политика и мениджмънт, 2023. 4, стр 23-28.
Велева Н., Икономика на здравеопазването, Издателски център на Медицински университет – Плевен, ISBN 978-954-756-194-6, стр. 204, 2016.
Vankova, D., Conceptual and Methodological Approaches to Quality of Life - a public health perspective, Scripta Scientifica Salutis Publicae, Volume 1, 2016, N 2, p. 7-13.
