Evidence-Based Recommendations on the Implementation of Shared Decision Making in Multiple Myeloma

OBJECTIVES: This study aimed to provide evidence-based recommendations to optimize patient involvement and enhance the implementation of Shared Decision Making (SDM) in Multiple Myeloma (MM) care across Europe. Ultimately, the overall project seeks to contribute to patient-centred care, optimize treatment decision-making, and improve patient outcomes in MM.

METHODS: Evidence-based recommendations were developed based on insights from semi-structured interviews and two surveys involving patients (n_interviews=39, n_survey=558) and healthcare providers (HCPs) (n_interviews=20, n_survey=89) across various countries. Subsequently, two multi-stakeholder workshops (patients (n=3), patient organization representatives (n=2), carers (n=2), haematologists (n=2), oncology nurses (n=3)), employing the Nominal Group Technique (NGT), were conducted to validate, refine and prioritize these recommendations.

RESULTS: A total of 24 recommendations were compiled on different levels (HCP (n=12) & patient (n=2), and organizational level (n=10)). Based on the NGT applied in the workshops, the top three recommendations at the level of the HCP and the patient include (1) ‘personalised approach of patient involvement’, (2) ‘personalised approach of providing information’, and (3) ‘patient preparation’. Participants unanimously agreed on the necessity of assessing how patients want to be involved in their treatment and which information they want to receive, acknowledging that preferences may evolve. Further, they found it important to prepare the patient for the consultation so that preferences can be indicated and the right questions can be asked. The top three organizational-level recommendations are (1) ‘Patient empowerment’, (2) ‘Creating awareness’, and (3) ‘Educational resources’. All three recommendations aim to reduce barriers for patient involvement and encourage patients’ active engagement in the SDM process.

CONCLUSIONS: The recommendations coming forward from this study seek to address key challenges in implementing SDM at all levels of MM care and identify specific steps to be taken by relevant stakeholders, such as developing a practical tool to support patients in the preparation of their consultation.