P-461: An overview of challenges experienced in multiple myeloma: perspectives of hematologist-oncologists and specialist nurses

Introduction: Multiple myeloma (MM) is a highly heterogeneous and incurable disease. Progress has been made to improve patient outcomes over recent years, but there is a need to better understand the challenges experienced by patients, to both improve the patient and carer experience, and support healthcare professionals (HCPs) to optimize care. As a first step, this research aims to identify challenges experienced in MM from an HCP perspective.

Methods: 1-hour in-depth, virtual, double-blind interviews were conducted between 09/13/22-11/09/22, with 18 hematologist-oncologists (hem-oncs) 44% of whom work in academic centers, and 4 specialist nurses, from 8 countries: US, UK, Spain, France, Germany, Italy, Japan, and Brazil. The interview questions covered 3 themes: the evolution and future of MM, the healthcare ecosystem, and perceived patient perspectives on current care. Key words were used to identify concepts discussed and quantify the qualitative data. Each interviewee discussed multiple concepts under each of the themes.

Results: Of 18 hem-oncs interviewed, 56% (n=10) stated that treatment decisions were a major challenge in MM care, a challenge identified globally. 28% (n=5) of hem-oncs cited cost concerns and limited treatment availability as further exacerbating the challenge of treatment decision making, particularly within self-pay markets such as the US and Brazil. 44% (n=8) stated that staying up to date with research, including novel therapies, is of utmost importance to move the MM field closer to cure.
72% (n=13) of hem-oncs stated that availability, cost, and the logistics of MM treatment remain a key practical challenge in the effective delivery of MM care. Further to this, only 17% (n=3) of hem-oncs stated that managing quality-of-life (QoL) in MM patients was challenging for them. In contrast, when hem-oncs were asked about what they perceive to be the biggest challenges for patients, 50% (n=9) stated QoL, side effect management, and psychological wellbeing as most concerning.
A sample of specialist nurses (n=4) were used to gain insight into areas of concern raised by MM patients during consultations. Cost and availability of treatment, logistical challenges of care, long waiting lists, and limited resources, including a lack of nurse time, were highlighted as overarching challenges, especially from EU countries. Other themes included delayed diagnosis, the need for multidisciplinary team input and improved access to supportive care.

Conclusions: Many challenges have been identified in the management of MM, highlighting existing unmet needs in MM care for both patients and HCPs. There is a need to corroborate the findings of this research with MM patients to better understand challenges and gaps in care from a patient perspective. Further research combined with multi-stakeholder efforts are needed to address these challenges and support the holistic needs of patients and HCPs. One such ongoing initiative is the MM Call-to-Action.