Survey of patients and physicians on shared decision-making in treatment selection in relapsed/refractory multiple myeloma

Abstract

Shared decision-making (SDM) is a key component of patient-centered healthcare. SDM is particularly pertinent in the relapsed and/or refractory multiple myeloma (RRMM) setting, in which numerous treatment options can present challenges for identifying optimal care. However, few studies have assessed the extent and relevance of SDM and patient-centered communication (PCC) in RRMM. To describe treatment decision-making patterns between physicians and patients in the RRMM setting, we conducted online surveys of patients and physicians in the USA to compare their perspectives on the process of treatment decision-making. We analyzed the surveys descriptively. Two hundred hematologists/oncologists and 200 patients with RRMM receiving second-line (n = 89), third-line (n = 65), and fourth-line (n = 46) therapy participated. Top treatment goals for physicians and patients included extending overall survival (among 76% and 83% of physicians and patients, respectively) and progression-free survival (among 54% and 77% of physicians and patients, respectively), regardless of the number of prior relapses. Thirty percent of physicians believed patients preferred a shared approach to treatment decision-making, while 40% of patients reported most often preferring a shared role in treatment decision-making. One-fourth of patients most often preferred physicians to make the final treatment decision after seriously considering their opinion. Thirty-two percent of physicians and 16% of patients recalled ≥3 treatment options presented at first relapse. Efficacy was a primary treatment goal for patients and physicians. Discrepancies in their perceptions during RRMM treatment decision-making exist, indicating that communication tools are needed to facilitate SDM and PCC.

Pain Management in Multiple Myeloma Patients: A Literature Review

“…SDM is a collaborative process where patients and providers make healthcare decisions together, considering both clinical evidence and patient preferences [ 22 , 40 - 41 ]. For patients with MM, SDM in pain management involves the following steps: first, providers assess pain intensity, location, and impact on daily life, fostering an open dialogue with patients.…”

“…For patients with MM, SDM in pain management involves the following steps: first, providers assess pain intensity, location, and impact on daily life, fostering an open dialogue with patients. Shared information includes potential causes and available interventions [ 40 - 41 ]. Second, providers present various pain management options, including medications, physical therapy, and complementary approaches.…”

“…Providers guide decisions based on both clinical expertise: evidence-based practice and patient input [ 4 ]. Data from Bylund et al's survey of patients and physicians on SDM in MM highlighted the positive impact on patient satisfaction and adherence to medication regimens [ 41 ].…”