More Support Needed to Mitigate Psychosocial Impacts of Multiple Myeloma

“Attention from the multidisciplinary team is necessary to ensure patients’ needs for information and support throughout the trajectory of their illness are met. This requires individual assessment at each clinical encounter to ensure that the care plan is optimized to meet the patient’s needs," according to the study authors.

Individualized clinical interventions are necessary for managing the psychosocial effects of advanced multiple myeloma among patients who lack access to resources that may help in managing physical and emotional disease-related challenges, according to findings from a qualitative study published in Canadian Oncology Nursing Journal.

Based on telephone interviews conducted with 12 adult patients with advanced multiple myeloma who were transfusion dependent or had undergone at least 3 prior lines of therapy, one of the themes that patients commonly experienced was the challenge surrounding the complexities of their individual diagnosis, disease status, prognosis, and treatment options.Some patients described feeling overwhelmed or had difficulty in understanding what their diagnosis or treatment course would entail. For example, one patient described the need for “someone to explain things in layman’s language” with respect to clarifying their disease status.

Patients also highlighted challenges with finding relevant information on how to anticipate the course of their disease. These challenges extended to accessing practical information that may help patients navigate the clinic, such as informing patients on the expected wait time of their chemotherapy.

Although patients expressed gratitude for the opportunity to receive treatment, some described experiences with chronic treatment-related adverse effects such as decline in physical function and pain. One patient stated that their participation in clinical trials led to “leg cramps” and “a bit of difficulty breathing” while another described that they would “get short of breath” after doing “a bit of walking around.”

Another theme related to the critical role that social support played in helping patients manage the conditions of their disease. Patients expressed appreciation for close friends, marital partners, and relatives who offered practical and emotional support to them. Moreover, patients often highlighted a need to have more access to information regarding their disease and treatment options, which included increasing the availability of psychosocial oncology resources.

“Individuals with advanced multiple myeloma have specific needs related to information, symptom management, and psychosocial support that require attention from the time of diagnosis and throughout the continuum of care. Special attention ought to be paid to patients who lack family support and/or struggle with medical literacy, from diagnosis onward,” the study authors wrote.

“Attention from the multidisciplinary team is necessary to ensure patients’ needs for information and support throughout the trajectory of their illness are met. This requires individual assessment at each clinical encounter to ensure that the care plan is optimized to meet the patient’s needs.”

Investigators of this study implemented an interpretive descriptive approach to evaluate the psychosocial effects that patients with multiple myeloma experience via telephone interviews from October 2020 to January 2021. Registered nurses, nurse practitioners, and social workers conducted interviews with 12 adult patients who were receiving ambulatory care for multiple myeloma in Toronto, Ontario, Canada.

Of 10 patients with available demographic data, 9 were White, 6 were male, and 5 had received a college education. All patients were actively receiving treatment for multiple myeloma at the time of the study (n = 10), most of whom were treated with autologous stem cell transplantation (n = 8) and lenalidomide (Revlimid; n = 4). According to the investigators, patients mostly experienced mild symptoms such as tiredness per Edmonton Symptom Assessment Scale scores.

“…Expanding access to appropriate and effective interventions to address any concerns identified through [individual] assessment is also needed. This may include myeloma-specific patient education, self-management support, or supportive care services to address physical and psychological issues including symptom control, physical fitness, emotional health, and social wellbeing. Specialized oncology nurses and nurse practitioners may be well positioned to lead innovations in this area,” the study authors concluded.

Reference

Rowland S, Forbes R, Howell D, et al. Psychosocial and supportive care needs of individuals with advanced myeloma. Can Oncol Nurs J. 2023;33(2):215-222. doi:10.5737/23688076332215