Review of the patient-centered communication landscape in multiple myeloma and other hematologic malignancies. Issue 9 (September 2019) - LeBlanc, Thomas W.
Highlights: Patient-centered communication (PCC) in hematology-oncology is not well understood. Multiple myeloma serves as a model for evaluating shared decision-making (SDM). Discordant information needs, treatment goals, and role preferences limit PCC/SDM. Educational programs may enhance communication in the hematology-oncology setting. Clinicians in hematology have the opportunity to proactively improve PCC. Abstract: Objectives: To identify factors limiting and facilitating patient-centered communication (PCC) in the United States hematology-oncology setting, with a focus on multiple myeloma (MM), given the limited attention to PCC and rapid pace of change that has taken place in this setting. Methods: A literature search was performed from 2007 to 2017 to identify published articles and congress abstracts related to clinician-patient communication and treatment decision-making in oncology. Search results were evaluated by year of publication and disease area. A thematic assessment was performed to identify factors limiting and promoting PCC for patients with MM and other hematologic malignancies. Results: Of the 6673 publications initially retrieved, 18 exclusively reported findings in patients with hematologic malignancies and were included in this review. We identified three critical, but modifiable, barriers to PCC in the hematologic malignancy setting, including insufficient information exchange, treatment goal misalignment, and discordant role preferences in treatment decision-making. Factors that enhanced interaction quality included educational programs for clinicians and patients. Conclusions: Patients with MM and other hematologic malignancies experience a distinct set of challenges that may affect PCC. Practice Implications: Clinicians have the opportunity to improve patient care by proactively addressing the identified barriers and implementing strategies demonstrated to improve PCC.