Quiz: Shared Decision-Making in Multiple Myeloma Treatment

November 13, 2019

In our multiple myeloma quiz, you'll get a chance to test your knowledge on best practices to implement shared decision-making when discussing treatment options with your patients.

In our multiple myeloma quiz, you'll get a chance to test your knowledge on best practices to implement shared decision-making when discussing treatment options with your patients. Here's your first question:

1. Shared decision-making between clinicians and patients about multiple myeloma treatment involves all except which of the following:

A. Education of patients about treatment options
B. Detailed discussions of treatment options
C. Clinician emphasis of the one best treatment option
D. Clinician support for patients’ exploration of each option

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Answer: C. Clinician emphasis of the one best treatment option. Multiple myeloma is the second most common hematologic malignancy and the growing number of treatment options and their complexity makes decision-making increasingly challenging, particularly for primarily older-adult and elderly patient populations. There is often no single recommended standard of care. Shared decision-making can improve patient care and involves patient education about treatment options, opportunities for detailed discussion about each treatment option, and clinician encouraging the patient to learn about each option to the patient’s satisfaction before reaching an informed treatment decision.

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2. For patients with multiple myeloma and other hematologic cancers, patient-centered communication offers which of the following benefits?

A. Improved patient confidence in treatment decisions
B. Improved treatment plan adherence
C. Improved quality of life
D. All of the above

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Answer: D. All of the above. Patient-centered communication involves learning and accommodating patients’ values, priorities and goals, including a patient’s preferred role in the decision-making process, and encouraging patients and supporting them in learning about and considering treatment options in light of their goals and values. Benefits of this approach include improved patient satisfaction and confidence with decisions about treatment, improved trust and treatment plan compliance, and improved health-related quality of life.

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3. ___% of patients with multiple myeloma report that they prefer collaborative shared treatment decision-making process.

A. 35
B. 45
C. 55
D. 65

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Answer: C. 55%. Patients’ preferred roles in multiple myeloma decision-making vary but most (55%) prefer to participate in a collaborative shared decision-making process. However, most patients felt their clinicians had made treatment decisions for them.

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4. ___ of elderly patients who were newly diagnosed with multiple myeloma described themselves as being in a state of shock or feeling overwhelmed, impacting their comprehension of information shared by clinicians.

A. 10%
B. 20%
C. 30%
D. 40%

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Answer: C. 30%. Surprise, dread and negative emotional reactions can limit patient attentiveness and comprehension following a diagnosis of multiple myeloma. Similar findings have been reported for patients with chronic myeloid leukemia and other cancers.

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5. Barriers to collaborative treatment decision-making with patients diagnosed with multiple myeloma or other hematologic malignancies include which of the following?

A. Clinician misunderstanding of patients’ treatment goals and values
B. Differing patient and clinician perceptions of what role a patient wishes to play in decision-making.
C. Clinician use of directive or deferential language styles
D. All of the above

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Answer: D. All of the above. Treatment decision-making involves effective communication and patient education. When clinicians misunderstand a patient’s values and goals for treatment or misunderstands a patient’s desired role in the decision-making process, communication becomes less effective. When clinicians use directive language styles, patients are often left believing the recommended treatment is “the” best or only real option, sometimes without understanding the criteria used by the clinician in making that recommendation.