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Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study.

Publication ,  Journal Article
Dombeck, C; Swezey, T; Gonzalez Sepulveda, JM; Reeve, BB; LeBlanc, TW; Chandler, D; Corneli, A
Published in: BMC Cancer
January 19, 2023

BACKGROUND: Advances in multiple myeloma treatment and a proliferation of treatment options have resulted in improved survival rates and periods of symptom-free remission for many multiple myeloma patients. As a result, health-related quality of life (HRQoL) concerns related to myeloma treatments have become increasingly salient for this patient population and represent an important consideration guiding patients' treatment choices. To gain an understanding of patients' experiences with choosing myeloma therapies and explore the HRQoL concerns that are most important to them, we interviewed a diverse sample of US-based multiple myeloma patients about their treatment considerations. METHODS: We conducted a qualitative descriptive study using in-depth interviews. Participants reflected on (1) the factors that were most important to them when thinking about multiple myeloma treatment and how these have changed over time, (2) how they might weigh the importance of treatment efficacy vs. side effects, (3) trade-offs they would be willing to make regarding efficacy vs. HRQoL, and (4) treatment changes they had experienced. Interviews were audio-recorded and transcribed, and narratives were analyzed using applied thematic analysis. RESULTS: We interviewed 21 patients, heterogeneous in their disease trajectory and treatment experience. Participants were 36 to 78 years, 52% female, and 38% Black. Efficacy was named as the most important treatment consideration by almost two-thirds of participants, and over half also valued HRQoL aspects such as the ability to maintain daily functioning and enjoyment of life. Participants expressed concern about potential treatment side effects and preferred more convenient treatment options. Although participants stated largely trusting their clinicians' treatment recommendations, many said they would stop a clinician-recommended treatment if it negatively impacted their HRQoL. Participants also said that while they prioritized treatment efficacy, they would be willing to change to a less efficacious treatment if side effects became intolerable. CONCLUSIONS: Our findings link to other reports reflecting considerations that are important to multiple myeloma patients, including the importance placed on increasing life expectancy and progression-free survival, but also the tension between treatment efficacy and quality of life. Our results extend these findings to a racially diverse US-based patient population at different stages in the disease trajectory.

Duke Scholars

Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

January 19, 2023

Volume

23

Issue

1

Start / End Page

65

Location

England

Related Subject Headings

  • Quality of Life
  • Qualitative Research
  • Oncology & Carcinogenesis
  • Multiple Myeloma
  • Male
  • Humans
  • Female
  • 4202 Epidemiology
  • 3211 Oncology and carcinogenesis
  • 1117 Public Health and Health Services
 

Citation

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Dombeck, C., Swezey, T., Gonzalez Sepulveda, J. M., Reeve, B. B., LeBlanc, T. W., Chandler, D., & Corneli, A. (2023). Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study. BMC Cancer, 23(1), 65. https://doi.org/10.1186/s12885-022-10458-x
Dombeck, Carrie, Teresa Swezey, Juan Marcos Gonzalez Sepulveda, Bryce B. Reeve, Thomas W. LeBlanc, David Chandler, and Amy Corneli. “Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study.BMC Cancer 23, no. 1 (January 19, 2023): 65. https://doi.org/10.1186/s12885-022-10458-x.
Dombeck C, Swezey T, Gonzalez Sepulveda JM, Reeve BB, LeBlanc TW, Chandler D, et al. Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study. BMC Cancer. 2023 Jan 19;23(1):65.
Dombeck, Carrie, et al. “Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study.BMC Cancer, vol. 23, no. 1, Jan. 2023, p. 65. Pubmed, doi:10.1186/s12885-022-10458-x.
Dombeck C, Swezey T, Gonzalez Sepulveda JM, Reeve BB, LeBlanc TW, Chandler D, Corneli A. Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study. BMC Cancer. 2023 Jan 19;23(1):65.
Journal cover image

Published In

BMC Cancer

DOI

EISSN

1471-2407

Publication Date

January 19, 2023

Volume

23

Issue

1

Start / End Page

65

Location

England

Related Subject Headings

  • Quality of Life
  • Qualitative Research
  • Oncology & Carcinogenesis
  • Multiple Myeloma
  • Male
  • Humans
  • Female
  • 4202 Epidemiology
  • 3211 Oncology and carcinogenesis
  • 1117 Public Health and Health Services