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Disparities in multiple myeloma care contribute to a mismatch in provider and patient understanding of patient challenges with the disease. By involving patients in the decision-making process, it becomes possible to tackle race-based disparities more effectively.

  • The risk of multiple myeloma is higher in Black/African American individuals.
  • Discrepancies exist among large institutions and community centers regarding how they address patient struggles and treatment goals.
  • Engaging patients in decision-making can help address race-based disparities.

Black/African American patients face a two-fold increase in lifetime risk of multiple myeloma compared to non-Black patients. However, they are less likely to receive new therapies and transplants or enroll in clinical trials.

Racial disparities in MM care arise due to decreased access to specialists and disparate resources at different institutions. In the academic setting, specialists have more access to clinical trials, advanced facilities, and molecular testing than community centers.

Surveying Patients and Providers on Challenges and Treatment Goals

In a study published in Current Oncology, surveys were conducted at two large hospital systems and four community centers in the United States to find out whether patients and providers were aligned on their perspectives towards the challenges MM patients face and goals of treatment.

Survey results showed signs of inequitable care and discrepancies between patient and provider perspectives. In both settings, more than one fourth of patients believed they had difficulty getting the best care because of their race. At the large hospital systems, patients and providers reported different patient challenges, showing a mismatch in understanding of patient struggles in larger care settings. At community centers, providers identified affordability and individualizing treatment plans as barriers to MM care.

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The Importance of Shared Decision-Making in Overcoming Disparities

Engaging patients in shared decision-making is necessary for overcoming disparities in MM. After a quality improvement initiative, providers were more confident in their ability to align treatment decisions with guidelines and clinical evidence. Specialists from academic and community systems prioritized individualizing treatment decisions, engaging patients more in decision-making, and ensuring greater equity in access to novel therapies.

This study highlights discordance between providers at large hospitals and community practices, and mismatched perceptions between providers and patients. Aligning treatment goals and accurately representing barriers to care in Black patients will be important  in addressing racial disparities in MM care moving forward.

Source: 

Mikhael, J. R., Sullivan, S. L., Carter, J. D., Heggen, C. L., & Gurska, L. M. (2023). Multisite Quality Improvement Initiative to Identify and Address Racial Disparities and Deficiencies in Delivering Equitable, Patient-Centered Care for Multiple Myeloma—Exploring the Differences between Academic and Community Oncology Centers. Current Oncology, 30(2), 1598–1613. MDPI AG. Retrieved from http://dx.doi.org/10.3390/curroncol30020123