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Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists.

Publication ,  Journal Article
LeBlanc, TW; Howson, A; Turell, W; Sheldon, P; Locke, SC; Tuchman, SA; Gasparetto, C; Kaura, S; Khan, ZM; Abernethy, AP
Published in: Curr Oncol
December 2016

BACKGROUND: Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how physicians view and implement guidelines and incorporate novel approaches into patient care. METHODS: We designed a semi-structured qualitative interview guide informed by literature review and an expert advisory panel. We conducted 60-minute interviews with a diverse sample of oncology physicians in the southeast United States. We used a constant comparative method to code and analyze interview transcripts. The research team and advisory panel discussed and validated emergent themes. RESULTS: Participants were 13 oncologists representing 5 academic and 4 community practices. Academic physicians reported using formal risk-stratification schemas; community physicians typically did not. Physicians also described differences in eligibility criteria for transplantation; community physicians emphasized distance, social support, and psychosocial capacity in making decisions about transplantation referral; the academic physicians reported using more specific clinical criteria. All physicians reported using a maintenance strategy both for post-transplant and for transplant-ineligible patients; however, determining the timing of maintenance therapy initiation and the response were reported as challenging, as was recognition or definition of relapse, especially in terms of when treatment re-initiation is indicated. CONCLUSIONS: Practices reported by both academic and community physicians suggest opportunities for interventions to improve patient care and outcomes through optimal multiple myeloma management and therapy selection. Community physicians in particular might benefit from targeted education interventions about risk stratification, transplant eligibility, and novel therapies.

Duke Scholars

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Published In

Curr Oncol

DOI

ISSN

1198-0052

Publication Date

December 2016

Volume

23

Issue

6

Start / End Page

e598 / e604

Location

Switzerland

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
LeBlanc, T. W., Howson, A., Turell, W., Sheldon, P., Locke, S. C., Tuchman, S. A., … Abernethy, A. P. (2016). Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists. Curr Oncol, 23(6), e598–e604. https://doi.org/10.3747/co.23.3298
LeBlanc, T. W., A. Howson, W. Turell, P. Sheldon, S. C. Locke, S. A. Tuchman, C. Gasparetto, S. Kaura, Z. M. Khan, and A. P. Abernethy. “Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists.Curr Oncol 23, no. 6 (December 2016): e598–604. https://doi.org/10.3747/co.23.3298.
LeBlanc, T. W., et al. “Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists.Curr Oncol, vol. 23, no. 6, Dec. 2016, pp. e598–604. Pubmed, doi:10.3747/co.23.3298.
LeBlanc TW, Howson A, Turell W, Sheldon P, Locke SC, Tuchman SA, Gasparetto C, Kaura S, Khan ZM, Abernethy AP. Risk stratification, treatment selection, and transplant eligibility in multiple myeloma: a qualitative study of the perspectives and self-reported practices of oncologists. Curr Oncol. 2016 Dec;23(6):e598–e604.

Published In

Curr Oncol

DOI

ISSN

1198-0052

Publication Date

December 2016

Volume

23

Issue

6

Start / End Page

e598 / e604

Location

Switzerland

Related Subject Headings

  • Oncology & Carcinogenesis
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis