BMJ Open. 2026 Sep 21;16(9):e108269. doi: 10.1136/bmjopen-2025-108269.
ABSTRACT
BACKGROUND: Multiple myeloma (MM) is a chronic haematological malignancy caused by the proliferation of malignant plasma cells in the bone marrow and overproduction of monoclonal antibodies. While no cure is available, treatments aim to control the disease and place patients into remission.
AIMS AND OBJECTIVES: This research aimed to explore the psychological impact and healthcare experiences of patients affected by triple-class refractory (TCR) MM. This research formed part of a wider qualitative study examining the experiences of newly diagnosed, double-class exposed and TCRMM patients.
METHODS: This qualitative, semi-structured interview study using Interpretative Phenomenological Analysis examined patient experiences. Patients were recruited through Myeloma UK, a charity for patients with MM and carers.
RESULTS: Seven patients diagnosed with TCRMM (five men and two women), aged 41-84 years (M=60 years, 3 months, SD=15 years) provided written consent. Two patients had become TCRMM within 6-12 months of MM diagnosis, one patient within 1-5 years and four patients over 5 years. Three overarching themes were identified that captured the key unmet needs of those affected by TCRMM: (1) Matching psychological support to specific moments identified drivers for regular psychological input at key points in the patient pathway; (2) Finding a voice in treatment decisions reflected patients' perceived lack of involvement in treatment decisions and their desire to be more engaged; and (3) Learning to navigate clinical trials highlighted the challenges associated with accessing transparent information about trials and the complexities of eligibility criteria.
CONCLUSIONS: The results demonstrate the psychological burden of TCRMM and the associated treatments across patient management and/or care. Likewise, patient access to informative materials and practical tools to support engagement in informed decision-making, specifically around treatments and clinical trials, needs to be more routinely offered and made available.
PMID:42767746 | DOI:10.1136/bmjopen-2025-108269