Flora Darcy R, Byrd Rachel, Platt Daniel A, Hlavacek Patrick, Hoag Goldman Erinn, Cappelleri Joseph C, Kennedy C Todd, LeBlanc Thomas W
Gryt Health Inc, Rochester, NY, USA.
Pfizer Inc, New York, NY, USA.
Patient Prefer Adherence. 2025 Apr 8;19:963-979. doi: 10.2147/PPA.S491263. eCollection 2025.
Multiple myeloma (MM) is characterized by treatment relapse and resistance, requiring sequential treatment decisions throughout its course. To understand how disease status and an evolving treatment landscape impact decisions made by patients and care partners, a non-interventional mixed methods study was conducted.
Patients self-reporting MM and care partners were recruited through the Gryt Health Cancer Community, social media, and snowball sampling to participate in this US-based study centered around a semi-structured interview. Patients were stratified by disease refractoriness to proteasome inhibitors, immunomodulatory drugs, and anti-CD38 antibodies.
Participants included 32 patients (75.0% diagnosed before age 60 years) and 10 care partners. The treatment landscape for MM has significantly changed over the years with increased complexity leading patients to seek specialist involvement earlier in their treatment. When rating factors influencing treatment decisions, participants prioritized extending remission and survival while improving quality of life. As patients progressed further from diagnosis, treatment decision-making became more collaborative, with patients exhibiting increased self-advocacy. Given the rapidly changing treatment landscape, participants had difficulty finding accurate, trustworthy, and easy-to-understand information. Younger patients were in a different life stage than the average patient with MM and expressed unique concerns and support needs (ie, reproductive health and future earnings). Aside from MM specialists, advocacy organizations and support groups played prominent roles in dispersing information that patients trusted and found empowering.
MM patients and care partners played an active role in treatment decision-making. Collaborative discussions between clinicians, patients, and care partners are crucial for building trust and empowering patients. Reliable information and support resources including those for younger patients are essential for addressing the changing needs of patients and care partners. Understanding the evolving care journey is necessary to support patients with MM to optimize treatment success.
多发性骨髓瘤(MM)的特点是治疗后复发和耐药,在其整个病程中需要连续做出治疗决策。为了解疾病状态和不断变化的治疗格局如何影响患者及其护理伙伴做出的决策,开展了一项非干预性混合方法研究。
通过Gryt Health癌症社区、社交媒体和滚雪球抽样招募自我报告患有MM的患者及其护理伙伴,以参与这项以半结构化访谈为中心的美国研究。患者根据对蛋白酶体抑制剂、免疫调节药物和抗CD38抗体的疾病难治性进行分层。
参与者包括32名患者(75.0%在60岁之前被诊断)和10名护理伙伴。多年来,MM的治疗格局发生了显著变化,复杂性增加,导致患者在治疗早期就寻求专科医生的参与。在对影响治疗决策的因素进行评分时,参与者将延长缓解期和生存期以及提高生活质量列为优先事项。随着患者从诊断后病情进一步发展,治疗决策变得更加协作,患者的自我主张也有所增加。鉴于治疗格局迅速变化,参与者难以找到准确、可靠且易于理解的信息。年轻患者处于与MM普通患者不同的生命阶段,表达了独特的担忧和支持需求(即生殖健康和未来收入)。除了MM专科医生外,倡导组织和支持团体在传播患者信任并认为具有赋权作用的信息方面发挥了重要作用。
MM患者及其护理伙伴在治疗决策中发挥了积极作用。临床医生、患者和护理伙伴之间的协作讨论对于建立信任和赋予患者权力至关重要。包括针对年轻患者的可靠信息和支持资源对于满足患者及其护理伙伴不断变化的需求至关重要。了解不断演变的护理过程对于支持MM患者优化治疗成功至关重要。