Practical recommendations for the implementation of shared decision-making in multiple myeloma care

BACKGROUND: Multiple myeloma (MM) is characterized by complex and evolving treatment pathways, involving multiple preference-sensitive decisions across the disease trajectory. Shared decision-making (SDM) is widely recognized as a best-practice approach for such decisions, yet practical, context-specific guidance for implementing SDM in MM care remains limited. OBJECTIVE: To develop a set of practical, stakeholder-informed recommendations to support the implementation of SDM in MM care. METHODS: This study was conducted as part of a European mixed-methods research project initiated by the patient organization Myeloma Patients Europe. Building on empirical studies involving MM patients and healthcare professionals (HCPs), an initial set of 24 recommendations was developed. These recommendations were subsequently refined, and agreed upon through two online multi-stakeholder workshops, involving patients, carers, hematologists, oncology nurses, and patient organization representatives from multiple European countries. Qualitative workshop data were thematically analyzed, and recommendations were consolidated through iterative team discussions. RESULTS: The final output comprises ten core recommendations addressing SDM implementation at multiple levels. Key themes included in the recommendations are adopting a personalized and preference-sensitive approach to patient involvement, tailoring information provision, openly discussing all treatment options including no treatment, strengthening multidisciplinary communication, supporting patient preparation and partnership, ensuring continuity of care, and providing structural, educational, and organizational support for SDM. CONCLUSIONS: These recommendations translate SDM principles into guiding considerations tailored to the specific challenges of MM care. They provide a foundation for context-sensitive implementation efforts aimed at strengthening patient-centered decision-making in MM.