Patient and provider-level drivers of healthcare utilization related to a diagnosis of a precancerous condition: monoclonal gammopathy of undetermined significance (MGUS)

Cancer Causes Control. 2023 May;34(5):449-457. doi: 10.1007/s10552-023-01675-1. Epub 2023 Feb 28.

Abstract

Purpose: Monoclonal gammopathy of undetermined significance (MGUS) is the precursor of multiple myeloma. This qualitative study described patient (n = 14) experiences and healthcare providers' (n = 8) opinions and practices concerning care for patients with MGUS in the US.

Methods: Semi-structured, in-depth interviews were analyzed using thematic analysis.

Results: We identified six overarching themes related to the care pathway for patients with MGUS: (1) Process of MGUS diagnosis, (2) Providers' explanations, (3) Patients' understanding, (4) Impact of the diagnosis, (5) Follow-up/management, and (6) Factors influencing healthcare utilization. Patients demonstrated a basic understanding of MGUS. However, some patients felt anxiety around the diagnosis, which may affect other aspects of their lives. Non-hematologist providers report having less MGUS-specific knowledge. Older age, high-risk MGUS, and insurance coverage/healthcare costs influenced healthcare utilization.

Conclusion: Patients with MGUS may have difficulty processing this premalignant diagnosis. Non-hematologist providers may have gaps in knowledge around specific care for patients with MGUS.

Keywords: Adult; Monoclonal gammopathy of undetermined significance; Multiple myeloma patients; Precancerous conditions; Qualitative research; United States.

MeSH terms

  • Disease Progression
  • Humans
  • Monoclonal Gammopathy of Undetermined Significance* / diagnosis
  • Monoclonal Gammopathy of Undetermined Significance* / therapy
  • Multiple Myeloma* / diagnosis
  • Patient Acceptance of Health Care
  • Precancerous Conditions* / diagnosis