Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study
Abstract 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 treat...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-022-10458-x |
| _version_ | 1828056789695856640 |
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| author | Carrie Dombeck Teresa Swezey Juan Marcos Gonzalez Sepulveda Bryce B. Reeve Thomas W. LeBlanc David Chandler Amy Corneli |
| author_facet | Carrie Dombeck Teresa Swezey Juan Marcos Gonzalez Sepulveda Bryce B. Reeve Thomas W. LeBlanc David Chandler Amy Corneli |
| author_sort | Carrie Dombeck |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-10T21:02:12Z |
| format | Article |
| id | doaj.art-7bcad58b71124c429565d7e34b6cea9d |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-10T21:02:12Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-7bcad58b71124c429565d7e34b6cea9d2023-01-22T12:16:36ZengBMCBMC Cancer1471-24072023-01-0123111010.1186/s12885-022-10458-xPatient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive studyCarrie Dombeck0Teresa Swezey1Juan Marcos Gonzalez Sepulveda2Bryce B. Reeve3Thomas W. LeBlanc4David Chandler5Amy Corneli6Department of Population Health Sciences, Duke University School of MedicineDepartment of Population Health Sciences, Duke University School of MedicineDepartment of Population Health Sciences, Duke University School of MedicineDepartment of Population Health Sciences, Duke University School of MedicineDepartment of Population Health Sciences, Duke University School of MedicineAmgen, IncDepartment of Population Health Sciences, Duke University School of MedicineAbstract 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.https://doi.org/10.1186/s12885-022-10458-xMultiple myelomaTreatment selectionTradeoffsHRQoLQualitative researchPatients |
| spellingShingle | Carrie Dombeck Teresa Swezey Juan Marcos Gonzalez Sepulveda Bryce B. Reeve Thomas W. LeBlanc David Chandler Amy Corneli Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study BMC Cancer Multiple myeloma Treatment selection Tradeoffs HRQoL Qualitative research Patients |
| title | Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study |
| title_full | Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study |
| title_fullStr | Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study |
| title_full_unstemmed | Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study |
| title_short | Patient perspectives on considerations, tradeoffs, and experiences with multiple myeloma treatment selection: a qualitative descriptive study |
| title_sort | patient perspectives on considerations tradeoffs and experiences with multiple myeloma treatment selection a qualitative descriptive study |
| topic | Multiple myeloma Treatment selection Tradeoffs HRQoL Qualitative research Patients |
| url | https://doi.org/10.1186/s12885-022-10458-x |
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