Shared Decision-Making in Treatment Selection in Multiple Myeloma in Spain: The PRISMMA Study

Abstract

INTRODUCTION: Perceptions and experiences of shared decision-making between patients and physicians in multiple myeloma (MM) care are not fully understood. A survey study was conducted to explore these perspectives in Spain. METHODS: Two anonymous online surveys, one for haematologists and one for MM patients, were developed. Both included related questions on treatment goals, treatment options discussion and the decision-making process. RESULTS: In total, 72 haematologists and 76 MM patients completed the survey, including 23 in first-line treatment, 37 in second-line or later and 16 with no or unknown treatment line. The most common treatment goal for patients (67%) and haematologists (90%) was to prolong survival with a good quality of life. Becoming symptom-free was the second most important treatment goal for patients and haematologists, followed by extending survival over quality of life for patients and quality of life over survival for haematologists. Both groups agreed that minimising hospital visits was the least important treatment goal. While 92% of haematologists reported discussing treatment goals with their patients, 17% of patients reported having this discussion. Discordances between haematologists and patients emerged in perceptions of who made the final treatment decision. CONCLUSION: While general agreement between patients and haematologists on extending survival with good quality of life was found for the main treatment goal, a need to align second treatment goals and improve the shared decision-making was identified. Addressing these differences is important to ensure the selection of the most appropriate treatment for the individual patient at each stage of their journey.