Shared Decision-Making in Multiple Myeloma

Jill Burke, NP, and Tanika Pittman, APRN, discuss incorporating shared decision-making into the long-term management of multiple myeloma, particularly as treatment goals expand beyond disease control to include quality of life and minimizing treatment burden. Jill emphasizes understanding the patient’s family structure, support system, personal circumstances, and goals, and describes revisiting these priorities as patients become more familiar with their treatment. She shares an example of a patient whose long-term goal was to travel to Patagonia, illustrating how personal goals can provide meaningful context for treatment planning and help patients work toward life milestones while managing multiple myeloma. Jill also highlights the APP role in identifying concerns about treatment tolerance and communicating these observations to the broader care team. Tanika frames shared decision-making as balancing two distinct considerations: the treatment approach that offers the desired level of disease control and the treatment burden that the patient is willing to accept. She notes that patient priorities may differ, with some individuals prioritizing maximal disease control while others place greater value on minimizing clinic time and preserving daily activities. The faculty emphasize discussing evidence, expected benefits, potential toxicities, treatment burden, and uncertainty, while recognizing that MRD information may make these conversations increasingly nuanced.