In a real-world study, researchers found that in patients with multiple myeloma (MM), poorer health-related quality of life (HRQoL) was linked to patient responses to a single question regarding pain severity. Study findings were recently reported in the journal Cancer Reports.

The study included 330 patients from Germany and Italy who were being treated for MM. In this analysis, HRQoL was evaluated using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaires (QLQs) C30 and MY20 and the Work Productivity and Activity Impairment (WPAI) questionnaire.

Physical pain severity in this study was evaluated using 1 question that asked for a description of pain as “no pain,” “mild,” “moderate,” or “severe.” The researchers performed statistical analyses including analysis of variance and Chi-square tests to evaluate any relationships between HRQoL scores and rankings of pain severity based on responses to this question.

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Pain severity was rated at no pain in 22.0% of patients, mild in 48.8% of patients, moderate in 24.6% of patients, and severe in 4.6% of patients in this analysis. Bone pain, specifically back pain, reflected the most common pain experiences reported in patients. Increased pain severity, from no pain to severe pain, was linked to worse overall HRQoL, with mean scores declining from 70.2 to 33.3, respectively, in this comparison (P <.001).

Individual components of HRQoL using the EORTC QLQ-C30 also showed patterns based on pain severity. In an evaluation of physical HRQoL, the comparison of no pain to severe pain was associated with mean HRQoL scores of 82.7 and 35.1, respectively. For social HRQoL, these scores were 81.1 and 44.4, respectively. For emotional HRQoL, these scores were 78.1 and 48.3, respectively. For HRQoL related to role functioning, these scores were 79.5 and 38.9, respectively. Fatigue burden showed mean scores of 26.0 with no pain and 68.9 with severe pain. P-values for each of these comparisons were P <.001.

On the WPAI questionnaire, usual activity impairment showed a link to pain severity. For this metric, mean scores were 35.4 with no pain and 71.4 with severe pain (P <.001). In 42 patients who were employed, absenteeism showed a trend of increase with self-reported pain severity (P =.06), while impairment experienced at work appeared more common with greater pain severity (P =.04).

“This study demonstrates that the use of a single question can capture the patient’s perspective on pain and HRQoL,” the researchers wrote in their report. They concluded that higher self-reported pain severity was associated with worse HRQoL in this patient population.

Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.


Ludwig H, Bailey AL, Marongiu A, et al. Patient-reported pain severity and health-related quality of life in patients with multiple myeloma in real world clinical practice. Cancer Rep (Hoboken). Published online June 10, 2021. doi:10.1002/cnr2.1429